Surgery for pre- and minimally invasive lung adenocarcinoma

被引:41
作者
Zhang, Yang [1 ,2 ,3 ,4 ]
Ma, Xiangyi [1 ,2 ,3 ,4 ]
Shen, Xuxia [3 ,4 ,5 ]
Wang, Shengping [3 ,5 ,6 ]
Li, Yuan [3 ,4 ,5 ]
Hu, Hong [1 ,2 ,3 ,4 ]
Chen, Haiquan [1 ,2 ,3 ,4 ]
机构
[1] Fudan Univ Shanghai Canc Ctr, Dept Thorac Surg, 270 Dong An Rd, Shanghai 200032, Peoples R China
[2] Fudan Univ Shanghai Canc Ctr, State Key Lab Genet Engn, Shanghai, Peoples R China
[3] Fudan Univ Shanghai Canc Ctr, Inst Thorac Oncol, Shanghai, Peoples R China
[4] Fudan Univ Shanghai Canc Ctr, Dept Oncol, Shanghai, Peoples R China
[5] Fudan Univ Shanghai Canc Ctr, Dept Pathol, Shanghai, Peoples R China
[6] Fudan Univ Shanghai Canc Ctr, Dept Radiol, Shanghai, Peoples R China
基金
中国国家自然科学基金;
关键词
adenocarcinoma in situ; minimally invasive adenocarcinoma; surgery; safety results; survival; CANCER; CLASSIFICATION; DIAGNOSIS; RESECTION;
D O I
10.1016/j.jtcvs.2020.11.151
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) are the pre- and minimally invasive forms of lung adenocarcinoma. We aimed to investigate safety results and survival outcomes following different types of surgical resection in a large sample of patients with AIS/MIA. Methods: Medical records of patients with lung AIS/MIA who underwent surgery between 2012 and 2017 were retrospectively reviewed. Clinical characteristics, surgical types and complications, recurrence-free survival, and overall survival were investigated. Results: A total of 1644 patients (422 AIS and 1222 MIA) were included. The overall surgical complication rate was significantly lower in patients receiving wedge resection (1.0%), and was comparable between patients undergoing segmentectomy (3.3%) or lobectomy (5.6%). Grade > 3 complications occurred in 0.1% of patients in the wedge resection group, and in a comparable proportion of patients in the segmentectomy group (1.5%) and the lobectomy group (1.5%). There was no lymph node metastasis. The 5-year recurrence-free survival rate was 100%. The 5-year overall survival rate in the entire cohort was 98.8%, and was comparable among the wedge resection group (98.8%), the segmentectomy group (98.2%), and the lobectomy group (99.4%). Conclusions: Sublobar resection, especially wedge resection without lymph node dissection, may be the preferred surgical procedure for patients with AIS/MIA. If there are no risk factors, postoperative follow-up intervals may be extended. These implications should be validated in further studies. (J Thorac Cardiovasc Surg 2022;163:456-64)
引用
收藏
页码:456 / 464
页数:9
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