IA期右中叶非小细胞肺癌患者肺叶切除术与肺段切除术的倾向评分匹配分析

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

作者信息

Lin Gang, Liu Haibo, Li Jian

机构信息

Department of Thoracic Surgery, Peking University First Affiliated Hospital, Peking University, Beijing 100034, China.

出版信息

J Thorac Dis. 2019 Jun;11(6):2523-2534. doi: 10.21037/jtd.2019.05.48.

DOI:10.21037/jtd.2019.05.48

PMID:31372289

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6626808/

Abstract

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.

摘要

背景

本研究旨在比较1:1倾向评分匹配（PSM）后接受肺叶切除术（LR）或肺叶下切除术（SLR）的IA期右中叶非小细胞肺癌（RML NSCLC）患者的预后结果。

方法

从2005年至2015年的监测、流行病学和最终结果（SEER）数据库中识别出IA期RML NSCLC患者。进行Cox回归分析以比较PSM前后接受LR或SLR后的肺癌特异性生存（LCSS）。还对按肿瘤大小（≤1、1-2和2-3 cm）分层的LCSS进行了亚组分析。

结果

共有1104例患者符合纳入标准。198例（17.9%）患者接受了SLR，906例（82.1%）接受了LR。LR组和SLR组患者在肿瘤大小和检查淋巴结数量方面存在显著差异。PSM后，选择了147对匹配对（n = 294）。多变量Cox回归分析显示，PSM前后接受LR或SLR的患者的LCSS没有差异[风险比（HR）：0.881，95%置信区间（CI）：0.547-1.422，P = 0.605]以及PSM后（HR：0.778，95% CI：0.409-1.480，P = 0.444）。亚组分析显示，LR组和SLR组患者在肿瘤大小方面的LCSS没有显著差异（所有P>0.05）。