Gabryel Piotr, Skrzypczak Piotr, Campisi Alessio, Kasprzyk Mariusz, Roszak Magdalena, Piwkowski Cezary
Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, Poland.
Department of Thoracic Surgery, University and Hospital Trust-Ospedale Borgo Trento, Piazzale Aristide Stefani 1, 37126 Verona, Italy.
Cancers (Basel). 2023 Jul 30;15(15):3877. doi: 10.3390/cancers15153877.
The standard of care for patients with early-stage non-small cell lung cancer (NSCLC) is anatomical lung resection with lymphadenectomy. This multicenter, retrospective, cohort study aimed to identify predictors of 5-year survival in patients after thoracoscopic lobectomy for stage IA NSCLC. The study included 1249 patients who underwent thoracoscopic lobectomy for stage IA NSCLC between 17 April 2007, and December 28, 2016. The 5-year survival rate equaled 77.7%. In the multivariate analysis, higher age (OR, 1.025, 95% CI: 1.002 to 1.048; = 0.032), male sex (OR, 1.410, 95% CI: 1.109 to 1.793; = 0.005), chronic obstructive pulmonary disease (OR, 1.346, 95% CI: 1.005 to 1.803; = 0.046), prolonged postoperative air leak (OR, 2.060, 95% CI: 1.424 to 2.980; < 0.001) and higher pathological stage (OR, 1.271, 95% CI: 1.048 to 1.541; = 0.015) were related to the increased risk of death within 5 years after surgery. Lobe-specific mediastinal lymph node dissection (OR, 0.725, 95% CI: 0.548 to 0.959; = 0.024) was related to the decreased risk of death within 5 years after surgery. These findings provide valuable insights for clinical practice and may contribute to improving the quality of treatment of early-stage NSCLC.
早期非小细胞肺癌(NSCLC)患者的标准治疗方法是进行肺叶切除及淋巴结清扫的解剖性肺切除术。这项多中心、回顾性队列研究旨在确定IA期NSCLC患者行胸腔镜肺叶切除术后5年生存率的预测因素。该研究纳入了2007年4月17日至2016年12月28日期间接受胸腔镜肺叶切除术治疗IA期NSCLC的1249例患者。5年生存率为77.7%。在多因素分析中,年龄较大(OR,1.025,95%CI:1.002至1.048;P = 0.032)、男性(OR,1.410,95%CI:1.109至1.793;P = 0.005)、慢性阻塞性肺疾病(OR,1.346,95%CI:1.005至1.803;P = 0.046)、术后漏气时间延长(OR,2.060,95%CI:1.424至2.980;P < 0.001)以及病理分期较高(OR,1.271,95%CI:1.048至1.541;P = 0.015)与术后5年内死亡风险增加相关。肺叶特异性纵隔淋巴结清扫(OR,0.725,95%CI:0.548至0.959;P = 0.024)与术后5年内死亡风险降低相关。这些发现为临床实践提供了有价值的见解,并可能有助于提高早期NSCLC的治疗质量。