Comparison of long-term prognosis in elderly stageⅠnon-small cell lung cancer patients undergoing lobectomy or segmentectomy: A propensity score matching study
- VernacularTitle:基于SEER数据库的老年Ⅰ期非小细胞肺癌患者肺叶和肺段切除术后远期预后的倾向性评分匹配研究
- Author:
Hui CUI
1
,
2
;
Yong SHI
1
,
2
;
Yongkang YU
1
,
2
;
Xiang HU
1
,
2
Author Information
1. Department of Thoracic and Cardiac Surgery, Meishan City People'
2. s Hospital, Meishan, 620010, Sichuan, P. R. China
- Publication Type:Journal Article
- Keywords:
Non-small cell lung cancer;
elderly patients;
stageⅠ;
lobectomy;
segmentectomy;
prognosis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(06):805-813
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the long-term prognosis of elderly patients with stageⅠnon-small cell lung cancer (NSCLC) after lobectomy or segmentectomy. Methods Data of elderly patients with stageⅠNSCLC between 2010 and 2020 were collected from the SEER database. According to the resection method, patients were divided into a lobectomy group and a segmentectomy group. The overall survival (OS) and lung cancer-specific survival (LCSS) of the two groups were compared by propensity score matching (lobectomy : segmentectomy=2 : 1). Results A total of 9990 patients were included, including 5840 (58.46%) females and 4150 (41.54%) males, with an average age of (70.48±6.47) years. Among them, 9029 patients were in the lobectomy group and 961 patients were in the segmentectomy group. After propensity score matching, a total of 2883 patients were matched, including 1 922 patients in the lobectomy group and 961 patients in the segmentectomy group. There was no statistical difference in baseline data between the two groups (P>0.05). The 10-year OS rate and LCSS rate of the lobectomy group were higher than those of the segmentectomy group (OS: 51.15% vs. 38.35%, P<0.01; LCSS: 79.68% vs. 71.52%, P<0.01). Subgroup analysis showed that the survival advantage of lobectomy was found in patients aged 60-<70 years and ≥80 years; for patients 70-<80 years, there was no statistical difference in OS or LCSS between the two surgical methods (P>0.05). In addition, for patients with tumor diameter ≤2 cm (stages ⅠA1-ⅠA2), lymph node dissection number≥10, and receiving adjuvant radiotherapy/chemotherapy, segmentectomy could also achieve a similar prognosis as lobectomy. Conclusion Overall, for elderly patients with stage ⅠNSCLC, lobectomy can achieve better OS and LCSS. However, individual differences, tumor characteristics, and perioperative treatment plans should be considered comprehensively to determine the surgical method for elderly patients with stageⅠNSCLC.
