Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

Tianxiang Chen; Jizhuang Luo; Rui Wang; Haiyong Gu; Yu Gu; Qingyuan Huang; Yiyang Wang; Jiajie Zheng; Yunhai Yang; Heng Zhao

doi:10.21037/jtd.2018.04.47

Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

J Thorac Dis. 2018 Apr;10(4):2231-2239. doi: 10.21037/jtd.2018.04.47.

Authors

Tianxiang Chen^{1

2}, Jizhuang Luo³, Rui Wang³, Haiyong Gu³, Yu Gu⁴, Qingyuan Huang³, Yiyang Wang³, Jiajie Zheng³, Yunhai Yang¹, Heng Zhao³

Affiliations

¹ Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
² School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325000, China.
³ Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
⁴ Department of Radiation Oncology, Shanghai Cancer Center, Fudan University, Shanghai 200030, China.

Abstract

Background: This study aimed to evaluate the prognostic difference between limited resection and lobectomy among elderly patients with small size lung adenocarcinoma.

Methods: A total of 666 patients >65 years old with stage I lung adenocarcinoma and tumor size ≤2 cm were included. The patient survival was evaluated by disease-free survival (DFS) and overall survival (OS). Results: No DFS or OS advantage was found between the lobectomy and wedge resection groups when tumor sizes were ≤1 cm (DFS, P=0.112; OS, P=0.294). The wedge resection group had a significantly worse OS (P=0.041) than that in the lobectomy group when tumor sizes were >1 cm and ≤2 cm.

Conclusions: We conclude that wedge resection may be a reasonable surgical choice for elderly patients with tumor sizes ≤1 cm.

Keywords: Invasive lung adenocarcinoma; lobectomy; resection; stage I; wedge resection.