Nakao Masayuki, Suzuki Ayumi, Ichinose Junji, Matsuura Yosuke, Okumura Sakae, Mun Mingyon
Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
J Surg Oncol. 2025 Mar;131(3):380-387. doi: 10.1002/jso.27927. Epub 2024 Oct 2.
A recent Japanese phase three clinical trial for lung cancer suggested a possible advantage of segmentectomy over lobectomy in terms of death from other diseases. This study aimed to compare the risk of death from other diseases based on surgical procedures in lung cancer patients without recurrence.
We retrospectively reviewed 2121 patients without disease recurrence after curative resection for lung cancer at our institution. Patient characteristics and overall survival were compared between sublobar resection and lobectomy.
The sublobar group (n = 595) had a significantly higher proportion of women, non-smokers, patients without comorbidities, patients with a history of other cancers, and patients with earlier-staged disease when compared with the lobectomy group (n = 1526). The overall survival was significantly longer in the sublobar group than in the lobectomy group (p = 0.0034). After adjusting for background characteristics in an analysis of 488 patients, the overall survival had a trend to be longer in the sublobar group than in the lobectomy group (p = 0.071).
Our results suggested that the risk of death from other diseases was potentially higher after lobectomy than after sublobar resection. Although several clinical factors could influence the results, these results may support the benefit of sublobar resection, assuming that the curability of both procedures is similar.
近期一项针对肺癌的日本三期临床试验表明，在因其他疾病导致的死亡方面，肺段切除术可能优于肺叶切除术。本研究旨在比较肺癌患者在无复发情况下基于手术方式的其他疾病死亡风险。
我们回顾性分析了本机构2121例肺癌根治性切除术后无疾病复发的患者。比较了亚肺叶切除组和肺叶切除组的患者特征及总生存期。
与肺叶切除组（n = 1526）相比，亚肺叶切除组（n = 595）女性、不吸烟者、无合并症患者、有其他癌症病史患者及疾病分期较早患者的比例显著更高。亚肺叶切除组的总生存期显著长于肺叶切除组（p = 0.0034）。在对488例患者进行背景特征调整分析后，亚肺叶切除组的总生存期有长于肺叶切除组的趋势（p = 0.071）。
我们的结果表明，肺叶切除术后因其他疾病导致的死亡风险可能高于亚肺叶切除术后。尽管有几个临床因素可能影响结果，但假设两种手术的治愈率相似，这些结果可能支持亚肺叶切除的益处。
