Clinical controlled comparison between lobectomy and segmental resection for patients over 70 years of age with clinical stage I non-small cell lung cancer

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• 作者：Y.D. Cheng^a ; C.J. Duan^b ; S. Dong^a ; H. Zhang^a ; S.K. Zhang^a ; S.Q. Wang^a ; C.F. Zhang^a ; ^{zcf6636169@sina.com}
• 关键词：Elderly lung cancer ; Lobectomy ; Segmental resection ; Lymph node dissection ; Pulmonary function
• 刊名：European Journal of Surgical Oncology (EJSO)
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：38
• 期：12
• 页码：1149-1155
• 全文大小：361 K

文摘

Aims

The standard surgical procedure for elderly (¡Ý70 years) patients with clinical stage I non-small cell lung cancer (NSCLC) was investigated.

Methods

A non-randomized prospective controlled study was conducted to compare lobectomy with segmental resection for the treatment of elderly clinical stage I lung cancer patients under different pulmonary function. Perioperative indicators including time and volume of thoracic drainage, incidence of postoperative complications, locoregional recurrence rates, and 1, 3, and 5-year survival rates were analyzed.

Results

A total of 184 patients were included in the study. Patients were classified into two groups according to pulmonary function: group 1 included 64 patients who had poor pulmonary function, with a forced expiratory volume in 1?s (FEV₁) of less than 1.5?L, whereas group 2 consisted of 120 patients with an FEV₁?¡Ý?1.5?L. The patients in group 1 had a longer postoperative mechanical ventilation time and a higher incidence rate of respiratory associated complications than those in group 2 (21.9 vs. 8.35 % , p?=?0.009). The local recurrence and long-term survival rates were not significantly different between lobectomy and segmental resection. Among the patients who underwent segmental resection, those who had regional lymph node dissection showed a higher 3-year and 5-year survival rate than those undergoing selected lymph node resection (77.8 vs. 51.7 % , p?=?0.042; 55.6 vs. 27.6 % , p?=?0.034), but this was not significant in lobectomy.

Conclusions

Segmental resection combined with regional lymph node resection could be the best choice for elderly clinical stage I NSCLC patients with FEV₁?<?1.5?L.