Lobectomy is the preferred choice rather than sublobar resection for centrally located clinical stage 1 non-small cell lung cancer

作者：Satoshi Takamori, Marina Nakatsuka, Hikaru Watanabe, Jun Suzuki, Makoto Endo, Satoshi Shiono · 发表于：European Journal of Cardio-Thoracic Surgery · 年份：2025 · DOI：10.1093/ejcts/ezaf233 · 被引用次数：7 · 研究领域：Lung Cancer Diagnosis and Treatment、Breast Cancer Treatment Studies、Hepatocellular Carcinoma Treatment and Prognosis

OBJECTIVES: Tumour location can affect clinicians' decisions regarding the surgical procedure, especially when choosing between lobectomy and segmentectomy. The biological behaviour of clinical stage I non-small cell lung cancer (NSCLC) may differ based on tumour location. We aimed to explore the biological behaviour of centrally located (CL) clinical stage I NSCLC and to identify which surgical procedure is more appropriate for such tumours. METHODS: This retrospective study included 719 patients who underwent curative operations for stage I NSCLC between April 2004 and December 2023. The biological behaviour of the tumours was analysed based on tumour location. Overall and recurrence-free survivals in patients who underwent lobectomy or more extensive procedures, including hilar and mediastinal lymph node dissection, were assessed based on tumour location. RESULTS: A total of 124 (17.2%) and 595 (82.8%) patients were included in the CL and peripherally located groups, respectively. The CL group had a significantly higher standardized uptake value maximum on positron emission tomography/computed tomography, a higher-grade adenocarcinoma subtype, and a higher frequency of lymph node metastasis than the peripherally located group. In multivariable analysis, CL and radiologically pure solid tumours (consolidation/tumour ratio = 1) were significant factors for occult lymph node metastasis. No significant difference was observed in survival based on tumour location. CONCLUSIONS: ...