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- Title
Risk factors for loss of pulmonary function after wedge resection for peripheral ground-glass opacity dominant lung cancer.
- Authors
Miyoshi, Tomohiro; Ito, Hiroyuki; Wakabayashi, Masashi; Hashimoto, Tadayoshi; Sekino, Yuta; Suzuki, Kenji; Tsuboi, Masahiro; Moriya, Yasumitsu; Yoshino, Ichiro; Isaka, Tetsuya; Hattori, Aritoshi; Mimae, Takahiro; Isaka, Mitsuhiro; Maniwa, Tomohiro; Endo, Makoto; Yoshioka, Hiroshige; Nakagawa, Kazuo; Nakajima, Ryu; Tsutani, Yasuhiro; Saji, Hisashi
- Abstract
Open in new tab Download slide OBJECTIVES This study aimed to identify the risk factors for pulmonary functional deterioration after wedge resection for early-stage lung cancer with ground-glass opacity, which remain unclear, particularly in low-risk patients. METHODS We analysed 237 patients who underwent wedge resection for peripheral early-stage lung cancer in JCOG0804/WJOG4507L, a phase III, single-arm confirmatory trial. The changes in forced expiratory volume in 1 s were calculated pre- and postoperatively, and a cutoff value of −10%, the previously reported reduction rate after lobectomy, was used to divide the patients into 2 groups: the severely reduced group (≤−10%) and normal group (>−10%). These groups were compared to identify predictors for severe reduction. RESULTS Thirty-seven (16%) patients experienced severe reduction. Lesions with a total tumour size ≥1 cm were significantly more frequent in the severely reduced group than in the normal group (89.2% vs 71.5%; P = 0.024). A total tumour size of ≥1 cm [odds ratio (OR), 3.287; 95% confidence interval (CI), 1.114–9.699: P = 0.031] and pleural indentation (OR, 2.474; 95% CI, 1.039–5.890: P = 0.041) were significant predictive factors in the univariable analysis. In the multivariable analysis, pleural indentation (OR, 2.667; 95% CI, 1.082–6.574; P = 0.033) was an independent predictive factor, whereas smoking status and total tumour size were marginally significant. CONCLUSIONS Of the low-risk patients who underwent pulmonary wedge resection for early-stage lung cancer, 16% experienced severe reduction in pulmonary function. Pleural indentation may be a risk factor for severely reduced pulmonary function in pulmonary wedge resection.
- Subjects
LUNG cancer; FORCED expiratory volume; PATIENT experience; WEDGES; CORNEAL opacity; PLEURA cancer
- Publication
European Journal of Cardio-Thoracic Surgery, 2023, Vol 64, Issue 6, p1
- ISSN
1010-7940
- Publication type
Article
- DOI
10.1093/ejcts/ezad365