Prognostic Analysis of Lobectomy versus Sublobar Resection in Patients Aged ≥60 Years with Stage Ia Small Cell Lung Cancer.
10.3779/j.issn.1009-3419.2018.01.02
- Author:
Haikang ZENG
1
;
Yang LIU
1
;
Xiaojun XIA
1
;
Jin LI
2
;
Jianxing HE
1
Author Information
1. Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
2. State Key Laboratory of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
- Publication Type:Journal Article
- Keywords:
Lobectomy;
Prognosis;
Radiochemotherapy;
SCLC;
Sub-lobectomy
- MeSH:
Aged;
Aged, 80 and over;
Female;
Humans;
Lung Neoplasms;
diagnosis;
surgery;
Male;
Middle Aged;
Pneumonectomy;
Prognosis;
Retrospective Studies;
Small Cell Lung Carcinoma;
diagnosis;
surgery
- From:
Chinese Journal of Lung Cancer
2018;21(1):8-15
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Currently, the prognosis of lobectomy and sub-lobectomy for the treatment of stage Ia small cell lung cancer (SCLC) is rarely reported. We retrospectively studied T1N0M0 (≤3 cm) SCLC patients aged ≥60 years, aiming to comparatively analyze the prognosis of lobectomy and sub-lobectomy in treating patients with Ia SCLC.
METHODS:Patients with stage Ia SCLC diagnosed by pathologic between 1992 and 2010 were selected from the "Surveillance, Epidemiology and End Results database"(SEER). Outcome data were compared using Kaplan-Meier (Log-rank test) and Cox model multivariate analysis.
RESULTS:We identified 515 patients. Median overall survival (OS) of the lobectomy (n=110), sublobar resection (n=57) and non-surgical (n=348) cohort were 45, 23 and 16 months, respectively. The corresponding 5-year OS of the three groups were 44%, 30%, and 14%, respectively. No significant difference in the prognosis of patients with or without lymph node examination/ dissection (P=0.107) and the 5-year OS of patients underwent lobectomy with chemoradiation was 50%. Cox multivariable analysis showed that operation treatment, including lobectomy and sublobectomy, was one of the independent factors associated with the prognosis of early SCLC patients, and patients undergo lobectomy shows a better OS compared with sublobar resection (Lob vs Sub, HR=0.645; 95%CI: 0.433-0.961, P=0.031).
CONCLUSIONS:For age ≥60 years T1N0M0 (≤3 cm) SCLC patients, we recommend anatomical lobectomy combined with adjuvant chemoradiation.
