共查询到20条相似文献,搜索用时 0 毫秒
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Hajime Saito Taku Nakagawa Manabu Ito Kazuhiro Imai Takashi Ono Yoshihiro Minamiya 《World journal of surgery》2014,38(8):2025-2031
Background
Several reports have shown that segmentectomy is superior to lobectomy for preservation of postoperative pulmonary function. The purpose of this study was to characterize the relationship between pulmonary function and the volume of the resected lung in patients undergoing segmentectomy or lobectomy.Methods
Patients undergoing open lobectomy (n = 126) and open segmentectomy (n = 52) for stage I non-small cell lung cancer were analyzed retrospectively. Pulmonary function testing, including vital capacity (VC) and forced expiratory volume in 1 second (FEV1), was performed preoperatively and at 1 and 6 months postoperatively.Results
The postoperative reduction of VC and FEV1, as indicated by the postoperative value/preoperative value, at 6 months after surgery was significantly less in the segmentectomy group than in the lobectomy group. However, the standardized functional loss ratio, as expressed by [(measured postoperative value)–(predicted postoperative value)] / (predicted postoperative value) × 100 (%), at 1 month after surgery was significantly lower in the segmentectomy group than in the lobectomy group. No significant difference in the standardized functional loss ratio was seen at 6 months postoperatively.Conclusions
Pulmonary function at 6 months after surgery is better after segmental resection than after lobectomy. However, the absolute value of pulmonary function did not reach the predicted-postoperative value at 1 month after surgery. Thus, when segmentectomy is performed, clinicians should be aware that early postoperative pulmonary function may be significantly less than the expected value. 相似文献6.
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Keith Sigel MD MPH Marcelo Bonomi MD Stuart Packer MD Juan Wisnivesky MD MPH 《Annals of surgical oncology》2009,16(7):1912-1917
Background Elderly patients with early-stage lung cancer are less likely to undergo tumor resection because of concerns about their ability
to tolerate surgery or perceived limited life expectancy. The objective of this study was to evaluate the impact of age and
competing risks on outcomes of elderly patients with stage I non-small-cell lung cancer (NSCLC).
Methods We identified 27,859 cases of histologically confirmed, stage I NSCLC from the Surveillance, Epidemiology, and End Results
registry. Patients were grouped by age (<60, 61–69, 70–79, ≥80 years) and surgical resection status. Relative survival rates
were compared amongst treatment groups by age strata to determine the potential impact of surgery and the contribution of
competing risks to overall mortality.
Results Patients aged <60, 61–69, 70–79, and ≥80 years represented 20%, 32%, 37%, and 11% of cases. The rate of surgical resections
declined from 95% of patients <60 years, to 79% of patients aged ≥80 years. While 5-year relative survival rates were somewhat
lower among males ≥80 years compared with those <60 years (63.5% versus 69.2%), there were no significant differences in relative
survival among resected women or unresected patients, regardless of sex. Most deaths in unresected patients were attributed
to lung cancer across all age groups.
Conclusions Elderly patients who undergo resection achieve relative survival rates that are comparable to their younger counterparts.
In unresected patients, lung cancer is the major source of mortality, even in the oldest age groups, suggesting that elderly
patients with stage I lung cancer should receive aggressive surgical management when possible. 相似文献
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Pablo León-Atance Nicolás Moreno-Mata Federico González-Aragoneses Miguel Ángel Cañizares-Carretero Enrique Poblet-Martínez Marta Genovés-Crespo María Dolores García-Jiménez Antonio Francisco Honguero-Martínez Carlos Alberto Rombolá Carlos María Simón-Adiego Rafael Peñalver-Pacual Emilio Álvarez-Fernández 《Archivos de bronconeumologia》2012,48(2):49-54
IntroductionIn the scientific literature, contradictory results have been published on the prognostic value of the loss of expression of blood group antigen A (BAA) in lung cancer. The objective of our study was to analyze this fact in our surgical series.Patients and methodsIn a multicenter study, 402 non-small-cell lung cancer (NSCLC) patients were included. All were classified as stage-I according to the last 2009-TNM classification. We analyzed the prognostic influence of the loss of expression of BAA in the 209 patients expressing blood group A or AB.ResultsThe 5-year cumulative survival was 73% for patients expressing BAA vs 53% for patients with loss of expression (P=.03). When patients were grouped into stages IA and IB, statistical significance was only observed in stage I-A (P=.038). When we analyzed the survival according to histologic type, those patients with adenocarcinoma and loss of expression of BAA had a lower survival rate that was statistically very significant (P=.003). The multivariate analysis showed that age, gender and expression of BAA were independent prognostic factors.ConclusionsThe loss of expression of blood group antigen A has a negative prognostic impact in stage I NSCLC, especially in patients with adenocarcinoma. 相似文献
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《The Annals of thoracic surgery》2023,115(1):184-190
BackgroundThis study compares the short- and long-term outcomes of open vs robotic vs video-assisted thoracoscopic surgery (VATS) lobectomy for stage II-IIIA non-small-cell lung cancer (NSCLC).MethodsOutcomes of patients with stage II-IIIA NSCLC (excluding T4 tumors) who received open and minimally invasive surgery (MIS) lobectomy in the National Cancer Database from 2010 to 2017 were assessed using propensity score-matched analysis.ResultsA propensity score-matched analysis of 4652 open and 4652 MIS patients demonstrated a decreased median length of stay associated with MIS compared with open lobectomy (5 vs 6 days; P < .001). There were no significant differences in 30-day mortality, 30-day readmission, or overall survival between the open and MIS groups. A propensity score-matched analysis of 1186 VATS and 1186 robotic patients showed that compared with VATS, the robotic approach was associated with no significant differences in 30-day mortality, 30-day readmission, and overall survival. However, the robotic group had a decreased median length of stay compared with VATS (4 vs 5 days; P < .001). The conversion rate was also significantly lower for robotic compared with VATS lobectomy (8.9% vs 15.9%, P < .001).ConclusionsNo significant differences were found in long-term survival between open and MIS lobectomy and between VATS and robotic lobectomy for stage II-IIIA NSCLC. However, the MIS approach was associated with a decreased length of stay compared with the open approach. The robotic approach was associated with decreased length of stay and decreased conversion rate compared with the VATS approach. 相似文献
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Selwyn O. RogersJr. Stacy W. Gray Mary Beth Landrum Carrie N. Klabunde Katherine L. Kahn Robert H. Fletcher Steven Clauser Diana Tisnado William Doucette Nancy L. Keating 《Annals of surgical oncology》2010,17(6):1581-1588
Background
Prior research suggests that older patients are less likely to undergo resection of early-stage non-small-cell lung carcinomas (NSCLCs). We surveyed surgeons to understand how their recommendations for lobectomy were influenced by age, the presence and severity of smoking-related lung disease, or by characteristics of the surgeons and their practices. 相似文献17.
《Seminars in thoracic and cardiovascular surgery》2022,34(2):712-723
Detailed Summary of Findings Comparing Wedge Resection to Lobectomy for Early Stage Non-Small Cell Lung Cancer. 相似文献
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Prognostic Factors in Resected Pathologic (p-) Stage IIIA-N2, Non-Small-Cell Lung Cancer 总被引:1,自引:1,他引:1
Tanaka F Yanagihara K Otake Y Kawano Y Miyahara R Takenaka K Katakura H Ishikawa S Ito H Wada H 《Annals of surgical oncology》2004,11(6):612-618
Background Postoperative prognosis for patients with pathologic (p-) stage IIIA-N2 non-small-cell lung cancer (NSCLC) is poor, and significant factors that influence the prognosis remain unclear.Methods A total of 99 patients who underwent complete resection for p-stage IIIA-N2 NSCLC without any preoperative therapy were retrospectively reviewed. Biological features such as tumor angiogenesis (intratumoral microvessel density [IMVD]), proliferative activity (proliferative index [PI]), and p53 status were also evaluated immunohistochemically.Results Univariate analysis revealed that the number of involved N2 stations was a significant prognostic factor; 5-year survival rates for a tumor with metastases in single N2 stations, tumor with metastases in two N2 stations, and tumor with metastases in 3 or more N2 stations were 41.6%, 35.3%, and 0.0%, respectively (P = .041) In addition, the 5-year survival rate for cN0-1 disease was significantly higher than that for cN2 disease (41.9% and 25.5%, respectively; P = .048) Tumor angiogenesis and proliferative activity were the most significant prognostic factors; 5-year survival rates for lower-IMDV tumor and higher-IMVD tumor were 53.6% and 15.9%, respectively (P = .002), and those for lower-PI tumor and higher-PI tumor were 47.0% and 20.4%, respectively (P = .019) There was no difference in the postoperative survival between tumor showing aberrant p53 expression and tumor showing no aberrant p53 expression. These results were confirmed by a multivariate analysis.Conclusions P-stage IIIA-N2 NSCLC cases represented a mixture of heterogeneous prognostic subgroups, and the number of involved N2 stations, cN status, PI, and IMVD were significant predictors of the survival. 相似文献
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P. De Leyn W. Rots G. Deneffe P. Nafteux W. Coosemans D. Van Raemdonck 《Acta chirurgica Belgica》2013,113(6):570-576
Sleeve lobectomy is a procedure in which the involved lobe with part of the main stembronchus is removed. The remaining lobe (s) is reimplanted on the main stembronchus. This procedure is indicated for central tumors of the lung as an altemative to pneumonectomy. It is the aim of this study to describe the technique of sleeve lobectomy and to analyse the early postoperative results and late results (survival-recurrence) after sleeve lobectomy for non-small-cell lung cancer.Material and methods: Between 1985 and 1999, 77 sleeve lobectomies for bronchogenic carcinoma were performed at the University hospitals Leuven. The most common performed sleeve lobectomy is the right upper lobe sleeve lobectomy (67,5%). In 6 patients a combined sleeve resection of the pulmonary artery was performed. The operative mortality was 3,9%. Two patients developed a broncho-pleural fistula. The five-year survival rate was 45,6%. In 5 patients, an anastomotic suture developed which required a completion pneumonectomy in 2. Thirteen patients developed local tumor recurrence.Conclusion: We conclude that sleeve lobectomy can be performed with an acceptable mortality and morbidity. Long term survival rate and recurrence rate are as good as after pneumonectomy. The operative mortality is lower when compared to pneumonectomy, exercise tolerance and quality of life are much better after sleeve lobectomy compared to pneumonectomy. For central tumours we believe that sleeve resection is the procedure of choice. 相似文献