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Survival Outcomes of Sublobectomy and Lobectomy in Elderly Patients with Peripheral Solid-Dominant Non-small Cell Lung Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

According to the JCOG0802 study, there were many non-cancer-related deaths in the lobectomy group. Meanwhile, the median age of the enrolled patients in the JCOG0802 study was 67 years old. Whether this difference in perioperative outcomes and survival outcomes is related to age remains unknown. We aim to investigate whether the sublobectomy was comparable to lobectomy in elderly (≥ 75 years old) patients with peripheral solid-dominant [50% ≤ consolidation tumor ratio (CTR) ≤ 1] and diameter ≤ 2 cm non-small cell lung cancer (NSCLC).

Methods

We retrospectively included 10,830 patients who underwent surgery treatment at two large-volume medical centers, Taizhou Hospital of Zhejiang Province and Shanghai Chest Hospital, from January 2016 to January 2018. Of these, 164 patients aged ≥ 75 years, tumor ≤ 2 cm, and 50% ≤ CTR ≤ 1 who received lobectomy or sublobectomy were included in our study. The perioperative outcomes, survival analyses, analysis of death patterns, tumor recurrence patterns, and Cox regression analyses were performed.

Results

On perioperative outcomes, sublobectomy was associated with a shorter operation time (p < 0.001), and in terms of survival outcomes, the 5-year overall survival (OS, p = 0.85) and 5-year disease-free surivial (DFS, p = 0.58) did not differ significantly between the two groups. The Cox regression analyses showed that CTR value, visceral pleural infiltration, and smoking were independent risk factors for worse OS. Furthermore, tumor recurrence pattern and death patterns between the two groups did not differ significantly.

Conclusions

Sublobectomy could achieve superior perioperative outcomes and equivalent oncological efficacy in comparison with lobectomy in elderly patients (≥ 75 years old) with peripheral solid-dominant and diameter ≤ 2 cm NSCLC.

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References

  1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.

    Article  Google Scholar 

  2. Brooks ED, Sun B, Zhao L, et al. Stereotactic ablative radiation therapy is highly safe and effective for elderly patients with early-stage non-small cell lung cancer. Int J Radiat Oncol Biol Phys. 2017;98:900–7.

    Article  Google Scholar 

  3. Clérigo V, Hasmucrai D, Teixeira E, et al. Characterization and management of elderly and very elderly patients with non-small cell lung cancer. Clin Respir J. 2020;14:683–6.

    Article  Google Scholar 

  4. Schellevis FG, van der Velden J, van de Lisdonk E, et al. Comorbidity of chronic diseases in general practice. J Clin Epidemiol. 1993;46:469–73.

    Article  CAS  Google Scholar 

  5. Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet (London, England). 2007;370:765–73.

    Article  Google Scholar 

  6. Pennathur A, Brunelli A, Criner GJ, et al. Definition and assessment of high risk in patients considered for lobectomy for stage I non-small cell lung cancer: the American Association for Thoracic Surgery expert panel consensus document. J Thorac Cardiovasc Surg 2021;162.

  7. Gu Y, Zhang J, Zhou Z, et al. Metastasis patterns and prognosis of octogenarians with NSCLC: a population-based study. Aging Dis. 2020;11:82–92.

    Article  Google Scholar 

  8. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg 1995;60:615-22; discussion 22–3.

  9. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022;399:1607–17.

    Article  CAS  Google Scholar 

  10. Aberle DR, DeMello S, Berg CD, et al. Results of the two incidence screenings in the National Lung Screening Trial. N Engl J Med. 2013;369:920–31.

    Article  CAS  Google Scholar 

  11. Miao XH, Yao YW, Yuan DM, et al. Prognostic value of the ratio of ground glass opacity on computed tomography in small lung adenocarcinoma: a meta-analysis. J Thorac Dis. 2012;4:265–71.

    Google Scholar 

  12. Huang TW, Lin KH, Huang HK, et al. The role of the ground-glass opacity ratio in resected lung adenocarcinoma. Eur J Cardiothorac Surg. 2018;54:229–34.

    Article  Google Scholar 

  13. Moon Y, Lee KY, Moon SW, et al. Sublobar resection margin width does not affect recurrence of clinical N0 non-small cell lung cancer presenting as GGO-predominant nodule of 3 cm or less. World J Surg. 2017;41:472–9.

    Article  Google Scholar 

Download references

Acknowledgement

The authors thank Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University and Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine for providing the research environment.

Funding

This study was supported by Grants from the National Natural Science Foundation of China (NSFC) (Grant No. 82002420), the National Natural Science Foundation of China (Grant No.82272679), Shanghai Talent Development Fund (Grant No.2019073), and the Natural Science Foundation of Zhejiang Province (Grant No. LY19H160018).

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Author notes

  1. Sikai Wu, Zimin Wang, Jiajing Sun and Han Wu have contributed equally to this article.

Authors and Affiliations

  1. Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China

    Sikai Wu MD, Zimin Wang MD, Zixian Jin MD, Bingyu Hu MD, Chengchu Zhu MD & Jianfei Shen MD, PhD

  2. Department of Thoracic Surgery, Taizhou Hospital, Zhejiang University, Taizhou, China

    Jiajing Sun MD & Sijia Ren MD

  3. Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China

    William C. Cho MD, PhD

  4. Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Han Wu MD & Tianxiang Chen MD, PhD

Authors
  1. Sikai Wu MD
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  2. Zimin Wang MD
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  3. Jiajing Sun MD
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  4. Han Wu MD
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  5. Zixian Jin MD
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  8. William C. Cho MD, PhD
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Contributions

S.W., Z.W., and J.S. drafted the manuscript. S.W., Z.J., S.R., and B.H. made and processed the figures and tables. W.C., H.W., and C.Z. revised the manuscript. T.C. and J.S. administrated this project. The author(s) read and approved the final manuscript.

Corresponding authors

Correspondence to Tianxiang Chen MD, PhD or Jianfei Shen MD, PhD.

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Wu, S., Wang, Z., Sun, J. et al. Survival Outcomes of Sublobectomy and Lobectomy in Elderly Patients with Peripheral Solid-Dominant Non-small Cell Lung Cancer. Ann Surg Oncol 30, 1522–1529 (2023). https://doi.org/10.1245/s10434-022-12909-y

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  • DOI: https://doi.org/10.1245/s10434-022-12909-y

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