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Distance between tumor and bronchial resection margin is an independent predictor of recurrence-free survival and overall survival in primary endobronchial neoplasm

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Abstract

Background

The distance between tumor and bronchial resection margin (DBTM) had no clear standard in lung cancer surgery. We aimed to select the optimal cut-off value to provide a standard for surgery of the patients with primary endobronchial neoplasm.

Methods

We retrospectively analyzed patients with primary endobronchial neoplasm who underwent surgical resection between 2005 and 2012. The receiver operating characteristic curves and the Youden index were used to calculate the optimal cut-off value of the DBTM. Propensity score matching was applied to reduce selection bias. Survival was assessed with Kaplan–Meier analysis, log-rank test and Cox proportional hazards model.

Results

A total of 1048 patients comprised in the study cohort and 1.7 cm was determined the optimal cut-off value, including 531 grouped in DBTM ≤ 1.7 cm and 517 grouped in DBTM > 1.7 cm. Before propensity score matching, the 5-year recurrence-free survival was 38.7% in DBTM ≤ 1.7 cm group and 67.1% in DBTM > 1.7 cm (hazard ratio 0.48, P < 0.001), while the 5-year overall survival was 30.1% and 50.7%, respectively (hazard ratio 0.64, P < 0.001). After propensity score matching, the 5-year recurrence-free survival was 38.8% in DBTM ≤ 1.7 cm group and 66.1% in DBTM > 1.7 cm (hazard ratio 0.51, P < 0.001), while the 5-year overall survival was 34.7% and 50%, respectively (hazard ratio 0.81, P = 0.012). Multivariable cox model showed that the DBTM was an independent predictor for recurrence-free survival (hazard ratio 0.51, P = 0.001) and overall survival (hazard ratio 0.84, P = 0.026).

Conclusions

The DBTM was an independent predictor for outcomes in primary endobronchial neoplasm, and patients with the DBTM ≤ 1.7 cm should actively receive adjuvant therapy after surgery.

Graphical abstract

The distance between tumor and bronchial resection margin (DBTM), the distance between the most proximal border of the macroscopic tumor and bronchial resection margin was measured by pathologist in the fresh specimens before formalin fixation. The DBTM less than 1.7cm had higher recurrence-free survival and overall survival and was an independent prognostic factor for patients with primary endobronchial neoplasm

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The data of this article will be shared on reasonable request to the corresponding author.

Abbreviations

IASLC:

International Association for the Study of Lung Cancer

NSCLC:

Non-small cell lung cancer

DBTM:

The distance between tumor and bronchial resection margin

PSM:

Propensity score matching

ROC:

Receiver operating characteristic

AUC:

Area under the ROC curve

IQR:

Interquartile range

SMD:

Standardized mean difference

HR:

Hazard ratio

CI:

Confidence interval

RFS:

Recurrence-free survival

OS:

Overall survival

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Acknowledgements

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Funding

This study was supported by the National Natural Science Foundations of China (NO. 82273119).

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Author notes

  1. Zengtuan Xiao, Mengzhe Zhang and Zuo Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and Hospital, Huanhu West Rd, Hexi District, Tianjin, China

    Zengtuan Xiao, Mengzhe Zhang, Zuo Liu, Xiaofei Wang & Zhenfa Zhang

  2. Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China

    Zengtuan Xiao & Zhe Liu

Authors
  1. Zengtuan Xiao
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  2. Mengzhe Zhang
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  3. Zuo Liu
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  4. Xiaofei Wang
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  5. Zhe Liu
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  6. Zhenfa Zhang
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Contributions

ZX: conceptualization; Formal analysis; Methodology; Writing- original draft; Writing-review & editing. MZ: Investigation; Validation; Writing original-draft; Writing-review & editing. ZL, Investigation; Formal analysis; Writing-review & editing. XW, Investigation; Resources. ZL, Formal analysis; Data curation; Writing-review & editing. ZZ, Conceptualization; Project administration; Resources; Writing- original draft; Writing-review & editing.

Corresponding author

Correspondence to Zhenfa Zhang.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval and consent to participate

This study was conducted in accordance with the Declaration of Helsinki. Our study was approved by the Ethic Committee of Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Approve number: bc2021134. Consent of patients for this retrospective study was waived.

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Xiao, Z., Zhang, M., Liu, Z. et al. Distance between tumor and bronchial resection margin is an independent predictor of recurrence-free survival and overall survival in primary endobronchial neoplasm. J Cancer Res Clin Oncol 149, 11171–11180 (2023). https://doi.org/10.1007/s00432-023-04917-6

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  • DOI: https://doi.org/10.1007/s00432-023-04917-6

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