Lobectomy plus lobe-specific lymphadenectomy as the minimum standards of curative resection for hypermetabolic clinical stage IA non-small cell lung cancer.

• Tác giả: Jianchuan Chen, Shugeng Gao, Jie He, Peng Li, Runze Li, Zhifei Li, Bin Qiu, Fengwei Tan, Qi Xue
• Ngôn ngữ: eng
• Ký hiệu phân loại: 782.6 +Womens voices
• Thông tin xuất bản: China : Translational lung cancer research , 2025
• Bộ sưu tập: NCBI
• ID: 170819

Tóm tắt

BACKGROUND: The results of three modern randomized controlled trials have proved sublobar resection as an effective procedure for early-stage non-small cell lung cancer (NSCLC) up to 2 cm. We aimed to examine whether sublobar resection is oncologically feasible and what constitutes adequate lymph node assessment for hypermetabolic clinical stage IA (cIA) NSCLC. METHODS: A single-center retrospective study was conducted in 589 patients who underwent lobectomy (n=526) or sublobar resection (n=63) for hypermetabolic cIA NSCLC [maximum standardized uptake value (SUVmax) ≥2.6 g/dL]. The primary outcomes (lung cancer-specific death and tumor recurrence) were compared in a competing risks framework for all patients and the propensity score matched pairs. Random forests were used to examine the variable importance for lung cancer-specific survival and tumor recurrence. Factors affecting pathological upstaging and recurrence-free survival were assessed by logistic regression analysis and Cox regression analysis, respectively. RESULTS: Sublobar resection had significantly higher lung cancer-specific cumulative incidence of death (LC-CID) and cumulative incidence of recurrence (CIR) than lobectomy after matching (5-year LC-CID, 20.8% CONCLUSIONS: Lobectomy was oncologically superior to sublobar resection as a curative-intent procedure for hypermetabolic cIA NSCLC. Lobectomy plus lobe-specific lymphadenectomy should be considered as the minimum standards of curative resection for hypermetabolic early-stage NSCLC in order to achieve more accurate pathological N staging and better cancer control.