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Comparison of survival outcomes between sublobar resection and lobectomies in early-stage lung adenocarcinoma by propensity score matching analysis

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Abstract

Background

The aim of this study was to investigate the clinical outcomes of sublobar resections and compare these with those of lobectomies in early-stage lung adenocarcinoma patients.

Methods

We retrospectively reviewed medical records of 871 patients who underwent lobectomies or sublobar resections for early-stage lung adenocarcinomas. Two hundred thirty-five (27.0%) patients underwent sublobar resections (wedge and segmentectomies), and 636 (73.0%) underwent lobectomies. Propensity score matching resulted in 2 groups each with 219 patients. Survival analysis was performed.

Results

Mean age of matched patients was 61.9 (± 10.38, range of 21 to 91) years, mean follow-up period was 50.8 (± 27.57, range of 6.1 to 128.9) months, and mean tumor size was 15.2 (± 6.49, range of 3.0 to 45.0) mm. Overall recurrence rate was 9.4% (41 patients), and it was 8.7% (19 patients) in sublobar resection patients and 9.6% (21 patients) in lobectomy patients. Rates and sites of recurrence were not significantly different between the two surgical groups (p = 0.500 and 0.401, respectively). Overall 5-year survival and recurrence-free survival of sublobar resection patients were 90.6 and 89.5%, respectively, whereas those of lobectomy patients were 91.9 and 88.3%, respectively. No significant differences in overall 5-year survival rate or recurrence-free survival rate were found between the two groups (p = 0.636 and p = 0.975, respectively).

Conclusions

Prognosis of early-stage lung adenocarcinoma treated with sublobar resection was not inferior to that treated with lobectomy in carefully selected cases. Further investigations, including randomized controlled trials, are needed to identify the equivalent oncologic efficacy of sublobar resections.

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Acknowledgments

We would like to thank the Division of Statistics in Medical Research Collaborating Center at Seoul National University Bundang Hospital for their help with statistical analyses. We are also grateful to Professor Emeritus J. Patrick Barron of Tokyo Medical University and adjunct professor of Seoul National University Bundang Hospital for editing this manuscript.

Funding

This study was supported by grant no. 02-2011-043 from the Seoul National University Bundang Hospital research fund.

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Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Seoul, South Korea

    Eunjue Yi

  2. Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea

    Sukki Cho, Kwhanmien Kim & Sanghoon Jheon

  3. Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, South Korea

    Sukki Cho, Kwhanmien Kim & Sanghoon Jheon

Authors
  1. Eunjue Yi
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  2. Sukki Cho
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  3. Kwhanmien Kim
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  4. Sanghoon Jheon
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Corresponding author

Correspondence to Sanghoon Jheon.

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This article does not have any studies with human participants or animals performed by any of the authors.

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The authors declare that they have no conflict of interest.

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Ethical statement

All procedures performed in this study were in accordance with the ethical standards of Seoul National University Bundang Hospital. This study was approved by the Institutional Review Board of Seoul National University Bundang Hospital in Seongnam, Republic of Korea (IRB number; B-1602-334-112).

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Yi, E., Cho, S., Kim, K. et al. Comparison of survival outcomes between sublobar resection and lobectomies in early-stage lung adenocarcinoma by propensity score matching analysis. Indian J Thorac Cardiovasc Surg 36, 382–387 (2020). https://doi.org/10.1007/s12055-019-00897-w

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  • DOI: https://doi.org/10.1007/s12055-019-00897-w

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