Better survival with lobectomy versus sublobar resection in patients with hypermetabolic c-stage IA lung cancer on positron emission tomography/computed tomography

作者：Satoshi Shiono, Makoto Endo, Hikaru Watanabe, Satoshi Takamori, Jun Suzuki · 发表于：European Journal of Cardio-Thoracic Surgery · 年份：2024 · DOI：10.1093/ejcts/ezae347 · 被引用次数：4 · 研究领域：Lung Cancer Diagnosis and Treatment、Lung Cancer Treatments and Mutations、Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis

OBJECTIVES: The clinical trial showed that sublobar resection was not inferior to lobectomy in terms of disease-free survival in patients with peripherally located non-small-cell lung cancer ≤2 cm. However, it is not clear whether sublobar resection is indicated for all types of c-stage IA lung cancer. The purpose of this study was to clarify whether sublobar resection is indicated for c-stage IA hypermetabolic lung cancer. METHODS: Patients with c-stage IA lung cancer who underwent F-18 fluorodeoxyglucose positron emission tomography/computed tomography and lobectomy or sublobar resection were assessed. Of these, patients who had a maximum standardized uptake value ≥3.0 on positron emission tomography/computed tomography were evaluated. We compared survival rates after lobectomy versus sublobar resection. Propensity score matching was performed to balance patient characteristics between groups. RESULTS: Between April 2004 and March 2023, 723 patients underwent lobectomy or sublobar resection and had a maximum standardized uptake value ≥3.0 on positron emission tomography/computed tomography. Lobectomy and sublobar resection were performed in 532 (73.6%) and 191 (26.4%) patients, respectively. Both the 5-year overall and disease-free survival rates were worse after sublobar resection compared with lobectomy (62.3% vs 79.9% and 53.9% vs 70.3%, respectively). After propensity score matching, the 5-year overall and disease-free survival rates remained worse after sublobar resect...