Lobectomy versus sub-lobar resection in patients with stage IA right middle lobe non-small cell lung cancer: a propensity score matched analysis.

BACKGROUND

The aim of the present study was to compare the prognostic outcomes of patients with stage IA right middle lobe non-small cell lung cancers (RML NSCLCs) that underwent either lobectomy (LR) or sub-lobar resection (SLR) after 1:1 propensity score matching (PSM).

METHODS

Patients with stage IA RML NSCLC were identified from the Surveillance, Epidemiology and End Results (SEER) database from 2005 to 2015. Cox regression analysis was carried out to compare lung cancer specific survival (LCSS) following LR or SLR before and after PSM. Subgroup analysis of LCSS stratified by tumor size (≤1, 1-2, and 2-3 cm) was also performed.

RESULTS

A total of 1,104 patients met the inclusion criteria. One hundred ninety-eight (17.9%) patients underwent SLR, and 906 (82.1%) underwent LR. There were significant differences between patients of LR and SLR groups with regard to the tumor size and the number of examined lymph nodes. After PSM, 147 matched pairs (n=294) were selected. Multivariable cox regression analysis revealed no difference in the LCSS of patients that underwent either LR or SLR before [hazard ratio (HR): 0.881, 95% CI: 0.547-1.422, P=0.605] and after PSM (HR: 0.778, 95% CI: 0.409-1.480, P=0.444). Subgroup analysis revealed no significant difference in LCSS between patients of LR and SLR groups with regard to the tumor size (all P>0.05).

CONCLUSIONS

Similar to lymphadenectomy, the prognostic outcomes in patients with stage IA RML NSCLC were comparable between LR and SLR.