Oncotarget

Clinical Research Papers:

Survival following segmentectomy or lobectomy in elderly patients with early-stage lung cancer

Yang Zhang _, Chongze Yuan, Yawei Zhang, Yihua Sun and Haiquan Chen

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Oncotarget. 2016; 7:19081-19086. https://doi.org/10.18632/oncotarget.7704

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Abstract

Yang Zhang1,2,*, Chongze Yuan1,2,*, Yawei Zhang1,2, Yihua Sun1,2, Haiquan Chen1,2,3,4

1Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China

3Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China

4Institutes of Biomedical Sciences, Fudan University, Shanghai, China

* These authors have contributed equally to this work

Correspondence to:

Haiquan Chen, e-mail: hqchen1@yahoo.com

Yihua Sun, e-mail: Sun_yihua76@hotmail.com

Keywords: non-small cell lung cancer, lobectomy, segmentectomy

Received: October 05, 2015     Accepted: February 06, 2016     Published: February 25, 2016

ABSTRACT

Purpose: To determine the survival following segmentectomy versus lobectomy in elderly patients with early-stage non-small cell lung cancer (NSCLC).

Methods: We identified 12324 elderly (≥ 70 years) patients with stage I ≤ 3 cm NSCLC in the Surveillance, Epidemiology and End Results (SEER) database. Propensity score methods were used to balance baseline characteristics of patients undergoing segmentectomy or lobectomy. Overall survival (OS) and lung cancer-specific survival (LCSS) of patients treated with segmentectomy versus lobectomy were compared in Cox regression models after adjusting, stratifying or matching patients based on propensity scores.

Results: Cox models adjusting, stratifying or matching propensity scores all showed that patients treated with segmentectomy had significantly worse OS and LCSS compared to lobectomy. Subgroup analysis of patients with tumors ≤ 2cm, aged ≥ 75 years, or had ≥ 7 lymph nodes examined also revealed survival advantage associated with lobectomy.

Conclusion: Elder age alone could not justify the application of segmentectomy in early-stage lung cancer. Prospective randomized trials are warranted to validate our results.


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