Clinical outcomes and changes in lung function after segmentectomy versus lobectomy for lung cancer cases

Bo Deng, Stephen D. Cassivi, Mariza De Andrade, Francis C. Nichols, Victor F. Trastek, Yi Wang, Jason A. Wampfler, Shawn M. Stoddard, Dennis A Wigle, Robert K. Shen, Mark S. Allen, Claude Deschamps, Ping Yang

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: We compared the clinical outcomes and changes in pulmonary function test (PFT) results after segmentectomy or lobectomy for non-small cell lung cancer.

Methods: The retrospective study included 212 patients who had undergone segmentectomy (group S) and 2336 patients who had undergone lobectomy (group L) from 1997 to 2012. The follow-up and medical record data were collected. We used all the longitudinal PFT data within 24 months postoperatively and performed linear mixed modeling. We analyzed the 5-year overall and disease-free survival in stage IA patients. We used propensity score case matching to minimize the bias due to imbalanced group comparisons.

Results: During the perioperative period, 1 death (0.4%) in group S and 7 (0.3%) in group L occurred. The hospital stay for the 2 groups was similar (median, 5.0 vs 5.0 days; range, 2-99 vs 2-58). The mean overall and disease-free survival period of those with T1a after segmentectomy or lobectomy seemed to be similar (4.2 vs 4.5 years, P = .06; and 4.1 vs 4.4 years, P = .07, respectively). Compared with segmentectomy, lobectomy yielded marginally significantly better overall (4.4 vs 3.9 years, P = .05) and disease-free (4.1 vs 3.6 years; P = .05) survival in those with T1b. We did not find a significantly different effect on the PFTs after segmentectomy or lobectomy.

Conclusions: Both surgical types were safe. We would advocate lobectomy for patients with stage IA disease, especially those with T1b. A retrospective study with a large sample size and more detailed information should be conducted for PFT evaluation, with additional stratification by lobe and laterality.

Original languageEnglish (US)
Pages (from-to)1186-1192.e3
JournalJournal of Thoracic and Cardiovascular Surgery
Volume148
Issue number4
DOIs
StatePublished - Oct 1 2014

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Segmental Mastectomy
Lung Neoplasms
Respiratory Function Tests
Lung
Disease-Free Survival
Retrospective Studies
Propensity Score
Perioperative Period
Non-Small Cell Lung Carcinoma
Sample Size
Medical Records
Length of Stay
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Clinical outcomes and changes in lung function after segmentectomy versus lobectomy for lung cancer cases. / Deng, Bo; Cassivi, Stephen D.; De Andrade, Mariza; Nichols, Francis C.; Trastek, Victor F.; Wang, Yi; Wampfler, Jason A.; Stoddard, Shawn M.; Wigle, Dennis A; Shen, Robert K.; Allen, Mark S.; Deschamps, Claude; Yang, Ping.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 148, No. 4, 01.10.2014, p. 1186-1192.e3.

Research output: Contribution to journalArticle

Deng, B, Cassivi, SD, De Andrade, M, Nichols, FC, Trastek, VF, Wang, Y, Wampfler, JA, Stoddard, SM, Wigle, DA, Shen, RK, Allen, MS, Deschamps, C & Yang, P 2014, 'Clinical outcomes and changes in lung function after segmentectomy versus lobectomy for lung cancer cases', Journal of Thoracic and Cardiovascular Surgery, vol. 148, no. 4, pp. 1186-1192.e3. https://doi.org/10.1016/j.jtcvs.2014.03.019
Deng, Bo ; Cassivi, Stephen D. ; De Andrade, Mariza ; Nichols, Francis C. ; Trastek, Victor F. ; Wang, Yi ; Wampfler, Jason A. ; Stoddard, Shawn M. ; Wigle, Dennis A ; Shen, Robert K. ; Allen, Mark S. ; Deschamps, Claude ; Yang, Ping. / Clinical outcomes and changes in lung function after segmentectomy versus lobectomy for lung cancer cases. In: Journal of Thoracic and Cardiovascular Surgery. 2014 ; Vol. 148, No. 4. pp. 1186-1192.e3.
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AU - Wang, Yi

AU - Wampfler, Jason A.

AU - Stoddard, Shawn M.

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AU - Allen, Mark S.

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N2 - Objective: We compared the clinical outcomes and changes in pulmonary function test (PFT) results after segmentectomy or lobectomy for non-small cell lung cancer.Methods: The retrospective study included 212 patients who had undergone segmentectomy (group S) and 2336 patients who had undergone lobectomy (group L) from 1997 to 2012. The follow-up and medical record data were collected. We used all the longitudinal PFT data within 24 months postoperatively and performed linear mixed modeling. We analyzed the 5-year overall and disease-free survival in stage IA patients. We used propensity score case matching to minimize the bias due to imbalanced group comparisons.Results: During the perioperative period, 1 death (0.4%) in group S and 7 (0.3%) in group L occurred. The hospital stay for the 2 groups was similar (median, 5.0 vs 5.0 days; range, 2-99 vs 2-58). The mean overall and disease-free survival period of those with T1a after segmentectomy or lobectomy seemed to be similar (4.2 vs 4.5 years, P = .06; and 4.1 vs 4.4 years, P = .07, respectively). Compared with segmentectomy, lobectomy yielded marginally significantly better overall (4.4 vs 3.9 years, P = .05) and disease-free (4.1 vs 3.6 years; P = .05) survival in those with T1b. We did not find a significantly different effect on the PFTs after segmentectomy or lobectomy.Conclusions: Both surgical types were safe. We would advocate lobectomy for patients with stage IA disease, especially those with T1b. A retrospective study with a large sample size and more detailed information should be conducted for PFT evaluation, with additional stratification by lobe and laterality.

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