胸外科英文文献汇报2017.11.23.pptxVIP

Anatomical Segmentectomy and Wedge ResectionsAre Associated with Comparable Outcomes for Patients with Small cT1N0 Non–Small Cell Lung Cancer肺段与肺楔形切除cT1N0 NSCLC对比分析 2017.11.23 Objectives Sublobar resection(亚肺叶切除) is advocated for patients with NSCLC and compromised cardiopulmonary reserve(心肺功能储备差), and for selected patients with early stage disease(选择性早期肺癌患者). Anatomic segmentectomy (AS) has traditionally been considered superior (优于) to wedge resection (WR), but well-balanced comparative studies are lacking. We hypothesize（猜测） that WR and AS are associated with comparable oncologic outcomes for patients with cT1N0 NSCLC. New York Presbyterian Hospital(美国纽约长老会医院) Stiles Thorac Oncol Methods A retrospective review （回顾性分析）of a prospective database （前瞻性数据库）was performed (2000–2014) for cT1N0 patients, excluding patients with multiple primary tumors, carcinoid tumors,adenocarcinoma in situ, and minimally invasive adenocarcinoma.（多原发肿瘤，类癌，原位腺癌，低侵袭性腺癌） Demographic（人口统计）, clinical, and pathological data were reviewed. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan-Meier method and differences compared using log-rank test（对数秩检验）. Multivariable analysis (MVA) （多变量分析）of factors affecting DFS was performed by Cox regression analysis（考克斯回归分析）. Methods For further comparison of the effect of resection type on survival, propensity score matching (i.e, by age, sex, Charlson comorbidity index（察尔森指数),percent forced expiratory volume in 1 second (FEV1%), clinical tumor size, and tumor maximum standardized uptake value(肿瘤最大标准化摄取值SUVmax) ,was performed to obtain balanced cohorts of patients undergoing WR and AS (n = 76 per group)图1，PSM匹配后患者的临床病理资料Results Two hundred eighty-nine patients met our selection criteria, including WR in 160 and AS in 129. Poor performance status and limited cardiopulmonary reserve were the primary indications for sublobar resection in 76% of WR patients and in 62% of AS patients (p ? 0.011). Thirteen patien