We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Comparison of thoracoscopic segmentectomy and thoracoscopic lobectomy on the patients with non-small cell lung cancer: a propensity score matching study.
- Authors
Yoohwa Hwang; Chang Hyun Kang; Hye-Seon Kim; Jae Hyun Jeon; In Kyu Park; Young Tae Kim
- Abstract
OBJECTIVES: Thoracoscopic lobectomy has been widely performed on patients with early-stage lung cancer; meanwhile indications of thoracoscopic segmentectomy have not been clearly defined due to technical difficulties and unclear oncological outcomes. The aim of this study was to compare early and late outcomes between thoracoscopic segmentectomy and thoracoscopic lobectomy. METHODS: Between January 2005 and December 2013, 100 thoracoscopic segmentectomies and 1049 thoracoscopic lobectomies were performed on patients with lung cancer in our institute. Preoperative clinical parameters including gender, age, tumour size, pathological stage, histology and forced expiratory volume in 1 s (FEV1) were used for propensity score matching. After propensity score matching, 94 thoracoscopic segmentectomies and 94 lobectomies were selected and compared. RESULTS: Thoracoscopic segmentectomies were performed on patients with normal lung function (mean FEV1 = 101.6 ± 24.1%), smallsized tumour (mean diameter 1.7 ± 1.0 cm), early-stage cancer (Stage I 93.7%) and predominant adenocarcinoma (81.9%). The lobectomy group had similar clinical features with the segmentectomy group. Most commonly performed procedures were left upper lobe upper division segmentectomy (19%) and right lower lobe superior segmentectomy (17%). Segmentectomies were performed in all lobes except the right middle lobe. There were no differences between segmentectomy and lobectomy in terms of operation time (166.3 ± 54.7 min vs 181.1 ± 85.2 min, P = 0.47) and hospital stay (6.2 ± 5.2 days vs 7.1 ± 7.1 days, P = 0.31). Incidence of postoperative complications was nonsignificantly higher in the lobectomy group (17.2 vs 10.6%, P = 0.1), and postoperative mortality rates were also non-significantly higher in the segmentectomy group (1.1 vs 2.1%, P = 0.56). Postoperative FEV1 decrease was non-significantly lower in the segmentectomy group (8.9 ± 10.8 vs 11.0 ± 13.1, P = 0.36). The 3-year overall survival and recurrence-free survival was not different between the two groups (94 and 87% in the segmentectomy group and 96 and 94% in the lobectomy group, P = 0.62 and P = 0.69, respectively). CONCLUSIONS: Thoracoscopic segmentectomy could achieve equal short-term surgical results and long-term oncological outcomes compared with thoracoscopic lobectomy.
- Subjects
LUNG cancer treatment; CHEST endoscopic surgery; LOBECTOMY (Lung surgery); NON-small-cell lung carcinoma; SURVIVAL analysis (Biometry)
- Publication
European Journal of Cardio-Thoracic Surgery, 2015, Vol 48, Issue 2, p273
- ISSN
1010-7940
- Publication type
Article
- DOI
10.1093/ejcts/ezu422