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Journal of Cancer Research and Clinical Oncology

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01-10-2017 | Original Article – Clinical Oncology

The indication of completion lobectomy for lung adenocarcinoma ≤3 cm after wedge resection during surgical operation

Authors: Yiyang Wang, Rui Wang, Difan Zheng, Baohui Han, Jie Zhang, Heng Zhao, Jizhuang Luo, Jiajie Zheng, Tianxiang Chen, Qingyuan Huang, Yihua Sun, Haiquan Chen

Published in: Journal of Cancer Research and Clinical Oncology | Issue 10/2017

Abstract

Purpose

This retrospective study was designed to find out the potential indications of completion lobectomy (CL) during wedge resection (WR) operation among patients with lung adenocarcinoma (ADC) ≤3 cm, by the use of Shanghai Chest Hospital Lung Cancer Database.

Patients and methods

There were totally 1938 patients in this study, including 746 WRs and 1192 CLs. The propensity score matching (PSM) was performed to minimize the effect of confounders. Univariable and multivariable cox regressions were analyzed to discover the independent risk factors of recurrence-free survival (RFS) and overall survival (OS). Subgroup analysis and Kaplan–Meier survival curves were performed if necessary.

Results

The 5-year RFS (86.1 vs 91.5%, p = 0.001 for unmatched group; 84 v 92%, p < 0.001 for PSM group) and OS (83.6 vs 91.7%, p < 0.001 for unmatched group; 81.6 vs 88.2%, p < 0.001 for PSM group) all indicated a better prognosis when conducting CL. Subgroup analysis suggested that WR was appropriate for non-invasive ADC. Three prognostic factors (sex, surgical approach and pleural invasion) were correlated with RFS and two (sex and surgical approach) corresponded with OS in invasive ADC through multivariable analysis. Non-lepidic-predominant component showed a better RFS and OS when CL was operated after WR in the subgroup of invasive ADC.

Conclusion

CL was an appropriate remediation to WR when the existence of invasive ADC, especially non-lepidic-predominant one. While WR could be applied if non-invasive ADC was confirmed. Whether lepidic-predominant adenocarcinoma was fit for WR needed further study.

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Title: The indication of completion lobectomy for lung adenocarcinoma ≤3 cm after wedge resection during surgical operation
Authors: Yiyang Wang
Rui Wang
Difan Zheng
Baohui Han
Jie Zhang
Heng Zhao
Jizhuang Luo
Jiajie Zheng
Tianxiang Chen
Qingyuan Huang
Yihua Sun
Haiquan Chen
Publication date: 01-10-2017
Publisher: Springer Berlin Heidelberg
Published in: Journal of Cancer Research and Clinical Oncology / Issue 10/2017
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-017-2452-0

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