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Sublobar resection versus lobectomy in patients aged ≤35 years with stage IA non-small cell lung cancer: a SEER database analysis

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

Sublobar resection has been increasingly adopted in elderly patients with stage IA non-small cell lung cancer (NSCLC), but the equivalency of sublobar resection versus lobectomy among young patients with stage IA NSCLC is unknown.

Methods

Using the Surveillance, Epidemiology, and End Results (SEER) registry, we identified patients aged ≤35 years who were diagnosed between 2004 and 2013 with pathological stage IA NSCLC and treated with sublobar resection or lobectomy. We used propensity-score matching to minimize the effect of potential confounders that existed in the baseline characteristics of patients in different treatment groups. The overall survival (OS) and lung cancer-specific survival (LCSS) rates of patients who underwent sublobar resection or lobectomy were compared in stratification analysis.

Results

Overall, we identified 188 patients who had stage IA disease, 32 (17%) of whom underwent sublobar resection. We did not identify any difference in OS/LCSS between patients who received sublobar resection versus lobectomy before (log-rank p = 0.6354) or after (log-rank p = 0.5305) adjusting for propensity scores. Similarly, we still could not recognize different OS/LCSS rates among stratified T stage groups or stratified lymph node-removed groups before or after adjusting for propensity scores.

Conclusions

Sublobar resection is not inferior to lobectomy for young patients with stage IA NSCLC. Considering sublobar resection better preserves lung function and has reduced overall morbidity, sublobar resection may be preferable for the treatment of young patients with stage IA NSCLC.

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Author notes

  1. Chang Gu, Rui Wang and Xufeng Pan contributed equally to this work.

Authors and Affiliations

  1. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China

    Chang Gu, Rui Wang, Xufeng Pan, Qingyuan Huang, Jun Yang & Jianxin Shi

  2. Department of Cardiovascular Surgery, East Hospital, Tongji University School of Medicine, Shanghai, 200120, China

    Yangyang Zhang

Authors
  1. Chang Gu
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  2. Rui Wang
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  3. Xufeng Pan
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  4. Qingyuan Huang
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  5. Yangyang Zhang
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  6. Jun Yang
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  7. Jianxin Shi
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Corresponding author

Correspondence to Jianxin Shi.

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Funding

This work was funded by National Natural Science Foundation of China (Grant no. 81572245), Shanghai Rising Star Program (Grant no. 16QA1403500) and Shanghai Municipal Commission of Health and Family Planning (Grant no. 20144Y0169).

Conflict of interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Gu, C., Wang, R., Pan, X. et al. Sublobar resection versus lobectomy in patients aged ≤35 years with stage IA non-small cell lung cancer: a SEER database analysis. J Cancer Res Clin Oncol 143, 2375–2382 (2017). https://doi.org/10.1007/s00432-017-2499-y

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  • DOI: https://doi.org/10.1007/s00432-017-2499-y

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