T1-2N0M0期小细胞肺癌患者肺叶切除术与肺段切除术对生存的影响
Lobectomy versus sublobar resection on survival in patients with stage T1-2N0M0 small cell lung cancer.
作者信息
Yin Xue, Liang Huan-Wei, Liu Yang, Huang Wei, Pan Xin-Bin
机构信息
Department of Oncology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China.
Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, P.R. China.
出版信息
PLoS One. 2025 May 14;20(5):e0324315. doi: 10.1371/journal.pone.0324315. eCollection 2025.
PURPOSE
To compare survival outcomes of lobectomy versus sublobar resection in patients diagnosed with stage T1-2N0M0 small cell lung cancer (SCLC).
MATERIALS AND METHODS
A comprehensive retrospective analysis was conducted using data from the Surveillance, Epidemiology, and End Results database. The Kaplan-Meier method was utilized to estimate cancer-specific survival (CSS) and overall survival (OS) between stage T1-2N0M0 SCLC patients undergoing sublobar resection and those receiving lobectomy.
RESULTS
A total of 185 patients were included in the analysis, with 64 undergoing sublobar resection and 121 receiving lobectomy. Before propensity score matching, lobectomy was associated with significantly better CSS (hazard ratio [HR] =, 95% confidence interval [CI]: 0.32, P = 0.006) and OS (HR =, 95% CI: 0.39, P = 0.005) compared to sublobar resection. Multivariable Cox regression analysis confirmed that lobectomy was an independent predictor of improved CSS (HR =, 95% CI: 0.24, P = 0.003) and OS (HR =, 95% CI: 0.36, P = 0.013). After propensity score matching, the differences in CSS (HR =, 95% CI: 0.36, P = 0.177) and OS (HR =, 95% CI: 0.46, P = 0.234) between the two surgical approaches were not statistically significant.
CONCLUSION
Lobectomy may offer improved survival outcomes compared to sublobar resection in patients with stage T1-2N0M0 SCLC.
目的
比较T1-2N0M0期小细胞肺癌（SCLC）患者肺叶切除术与肺段以下切除术的生存结果。
材料与方法
利用监测、流行病学和最终结果数据库的数据进行全面的回顾性分析。采用Kaplan-Meier方法估计接受肺段以下切除术和肺叶切除术的T1-2N0M0期SCLC患者的癌症特异性生存（CSS）和总生存（OS）。
结果
分析共纳入185例患者，其中64例行肺段以下切除术，121例行肺叶切除术。在倾向评分匹配前，与肺段以下切除术相比，肺叶切除术的CSS（风险比[HR]=，95%置信区间[CI]：0.32，P=0.006）和OS（HR=，95%CI：0.39，P=0.005）显著更好。多变量Cox回归分析证实，肺叶切除术是CSS改善（HR=，95%CI：0.24，P=0.003）和OS改善（HR=，95%CI：0.36，P=0.013）的独立预测因素。倾向评分匹配后，两种手术方式在CSS（HR=，95%CI：0.36，P=0.177）和OS（HR=，95%CI：0.46，P=0.234）上的差异无统计学意义。
结论
对于T1-2N0M0期SCLC患者，与肺段以下切除术相比，肺叶切除术可能提供更好的生存结果。
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