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.
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.
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.