Intentional wedge resection versus segmentectomy for ≤2 cm ground-glass-opacity-dominant non-small cell lung cancer: a real-world study using inverse probability of treatment weighting

医学 磨玻璃样改变 楔形切除术 肺癌 比例危险模型 切除术 外科 癌症 内科学 腺癌
作者
Chengwu Liu,Zhenyu Yang,Yiming Li,Chenglin Guo,Liang Xia,Weiheng Zhang,Congjia Xiao,Jiandong Mei,Hu Liao,Yunke Zhu,Feng Lin,Lin Ma,Qiang Pu,Lunxu Liu
出处
期刊:International Journal of Surgery [Wolters Kluwer]
被引量:4
标识
DOI:10.1097/js9.0000000000001361
摘要

Background: Whether wedge resection is oncological suitable for ground glass opacity (GGO)-dominant non-small cell lung cancer (NSCLC) ≤2 cm is still debatable. The aim of this study is to investigate the short-term and long-term outcomes of intentional wedge resection and segmentectomy for those patients. Materials and Methods: This was a real-world study from one of the largest thoracic surgery centers in XX. Patients who underwent intentional wedge resection or segmentectomy for ≤2 cm CTR(consolidation-to-tumor)≤0.5 NSCLC were consecutively included between December 2009 and December 2018. Data were prospectively collected and retrospectively reviewed. Inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics. Long-term outcomes, including overall survival (OS), recurrence-free survival (RFS) and lung cancer-specific survival (LCSS), were analyzed using Cox proportional model. Results: A total of 1209 patients were included (497 in the wedge resection group, 712 in the segmentectomy group). Compared to segmentectomy, wedge resection had a significantly lower rate of complications (3.8% vs. 7.7%, P =0.008), a shorter operating time (65min vs. 114min, P <0.001), and a shorter postoperative stay (3d vs. 4d, P <0.001). The median follow-up was 70.1 months. The multivariate Cox model indicated that wedge resection had survival outcomes that were similar to segmentectomy in terms of 5-year OS (98.8% vs. 99.6%, HR=1.98, 95%CI: 0.59-6.68, P =0.270), 5-year RFS (98.8% vs. 99.5%, HR=1.88, 95%CI: 0.56-6.31, P =0.307) and 5-year LCSS (99.9% vs. 99.6%, HR=1.76, 95%CI: 0.24-13.15, P =0.581). Conclusion: Intentional wedge resection is an appropriate choice for ≤2 cm GGO-dominant NSCLC.
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