Efficacy of thoracoscopic segmentectomy versus lobectomy in the treatment of early invasive lung adenocarcinoma: a propensity score matching study
ObjectiveThis study aimed to investigate and analyze the clinical application value of thoracoscopic segmentectomy and lobectomy in patients with invasive pulmonary adenocarcinoma.Methods286 patients with invasive pulmonary adenocarcinoma who underwent segmentectomy or lobectomy at the First Hospita...
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| Format: | Article |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1186991/full |
| _version_ | 1797730112094863360 |
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| author | Congyi Ding Qiyu Jia Zhongjie Wu Yanfei Zhang Yi Hu Jingyu Wang Dahai Wei |
| author_facet | Congyi Ding Qiyu Jia Zhongjie Wu Yanfei Zhang Yi Hu Jingyu Wang Dahai Wei |
| author_sort | Congyi Ding |
| collection | DOAJ |
| description | ObjectiveThis study aimed to investigate and analyze the clinical application value of thoracoscopic segmentectomy and lobectomy in patients with invasive pulmonary adenocarcinoma.Methods286 patients with invasive pulmonary adenocarcinoma who underwent segmentectomy or lobectomy at the First Hospital of Jiaxing City from January 2018 to June 2020 were retrospectively analyzed. Patients were divided into a thoracoscopic segmentectomy group(n=97) and a lobectomy group (n=189). Patients were compared after obtaining 1:1 propensity score-matched cohorts. Outcome indicators included surgery-related indicators, immune-inflammation-related indicators, postoperative complications, recurrence, and metastasis.ResultsAfter 1:1 propensity score matching, 93 patients were included in each group. We found that the volume of intraoperative blood loss in the segmentectomy group was significantly less than in the lobectomy group (P=0.014). The duration of postoperative drainage (P = 0.005) and hospitalization (P=0.002) in the segmentectomy group were significantly shorter than in the lobectomy group. In terms of immunoinflammatory response, compared with the lobectomy group, white blood cells, neutrophils, SII, and NLR in the segmentectomy group were significantly lower than in the lobectomy group (P< 0.05). The recurrence-free survival (RFS) rates in the segmentectomy and lobectomy were 80.5% and 88.2% at 1 year and 35.1% and 52.6% at 3 years, respectively, and the difference was statistically significant (P<0.05). The segmentectomy group achieved similar outcomes to the lobectomy group at 1 year and 3 years (P > 0.05). Multivariate COX regression analysis showed that CAR was an independent risk factor for RFS in patients undergoing invasive adenocarcinoma surgery.ConclusionCompared with lobectomy, thoracoscopic segmentectomy can effectively reduce the postoperative inflammatory response in patients with early invasive lung adenocarcinoma and promote patient recovery. Although segmentectomy is associated with a higher recurrence rate in the short term for patients with early invasive lung adenocarcinoma, the associated survival rate is similar to the lobectomy group. Segmentectomy should be considered in the treatment of early invasive lung adenocarcinoma. Meanwhile, postoperative CAR represents an independent risk factor for early postoperative recurrence in patients with IAC. |
| first_indexed | 2024-03-12T11:39:33Z |
| format | Article |
| id | doaj.art-59e5d79327ac467eb13c490fc814a949 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-12T11:39:33Z |
| publishDate | 2023-08-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-59e5d79327ac467eb13c490fc814a9492023-08-31T20:10:07ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-08-011310.3389/fonc.2023.11869911186991Efficacy of thoracoscopic segmentectomy versus lobectomy in the treatment of early invasive lung adenocarcinoma: a propensity score matching studyCongyi Ding0Qiyu Jia1Zhongjie Wu2Yanfei Zhang3Yi Hu4Jingyu Wang5Dahai Wei6Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Jiaxing, Zhejiang, ChinaDepartment of Trauma Orthopedics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, ChinaDepartment of Cardiothoracic Surgery, The First Hospital of Jiaxing, Jiaxing, Zhejiang, ChinaDepartment of Cardiothoracic Surgery, The First Hospital of Jiaxing, Jiaxing, Zhejiang, ChinaDepartment of Cardiothoracic Surgery, The First Hospital of Jiaxing, Jiaxing, Zhejiang, ChinaDepartment of Cardiothoracic Surgery, The First Hospital of Jiaxing, Jiaxing, Zhejiang, ChinaDepartment of Cardiothoracic Surgery, The First Hospital of Jiaxing, Jiaxing, Zhejiang, ChinaObjectiveThis study aimed to investigate and analyze the clinical application value of thoracoscopic segmentectomy and lobectomy in patients with invasive pulmonary adenocarcinoma.Methods286 patients with invasive pulmonary adenocarcinoma who underwent segmentectomy or lobectomy at the First Hospital of Jiaxing City from January 2018 to June 2020 were retrospectively analyzed. Patients were divided into a thoracoscopic segmentectomy group(n=97) and a lobectomy group (n=189). Patients were compared after obtaining 1:1 propensity score-matched cohorts. Outcome indicators included surgery-related indicators, immune-inflammation-related indicators, postoperative complications, recurrence, and metastasis.ResultsAfter 1:1 propensity score matching, 93 patients were included in each group. We found that the volume of intraoperative blood loss in the segmentectomy group was significantly less than in the lobectomy group (P=0.014). The duration of postoperative drainage (P = 0.005) and hospitalization (P=0.002) in the segmentectomy group were significantly shorter than in the lobectomy group. In terms of immunoinflammatory response, compared with the lobectomy group, white blood cells, neutrophils, SII, and NLR in the segmentectomy group were significantly lower than in the lobectomy group (P< 0.05). The recurrence-free survival (RFS) rates in the segmentectomy and lobectomy were 80.5% and 88.2% at 1 year and 35.1% and 52.6% at 3 years, respectively, and the difference was statistically significant (P<0.05). The segmentectomy group achieved similar outcomes to the lobectomy group at 1 year and 3 years (P > 0.05). Multivariate COX regression analysis showed that CAR was an independent risk factor for RFS in patients undergoing invasive adenocarcinoma surgery.ConclusionCompared with lobectomy, thoracoscopic segmentectomy can effectively reduce the postoperative inflammatory response in patients with early invasive lung adenocarcinoma and promote patient recovery. Although segmentectomy is associated with a higher recurrence rate in the short term for patients with early invasive lung adenocarcinoma, the associated survival rate is similar to the lobectomy group. Segmentectomy should be considered in the treatment of early invasive lung adenocarcinoma. Meanwhile, postoperative CAR represents an independent risk factor for early postoperative recurrence in patients with IAC.https://www.frontiersin.org/articles/10.3389/fonc.2023.1186991/fullinvasive adenocarcinoma of lungsegmentectomylobectomyimmunoinflammatory responseretrospective analysis |
| spellingShingle | Congyi Ding Qiyu Jia Zhongjie Wu Yanfei Zhang Yi Hu Jingyu Wang Dahai Wei Efficacy of thoracoscopic segmentectomy versus lobectomy in the treatment of early invasive lung adenocarcinoma: a propensity score matching study Frontiers in Oncology invasive adenocarcinoma of lung segmentectomy lobectomy immunoinflammatory response retrospective analysis |
| title | Efficacy of thoracoscopic segmentectomy versus lobectomy in the treatment of early invasive lung adenocarcinoma: a propensity score matching study |
| title_full | Efficacy of thoracoscopic segmentectomy versus lobectomy in the treatment of early invasive lung adenocarcinoma: a propensity score matching study |
| title_fullStr | Efficacy of thoracoscopic segmentectomy versus lobectomy in the treatment of early invasive lung adenocarcinoma: a propensity score matching study |
| title_full_unstemmed | Efficacy of thoracoscopic segmentectomy versus lobectomy in the treatment of early invasive lung adenocarcinoma: a propensity score matching study |
| title_short | Efficacy of thoracoscopic segmentectomy versus lobectomy in the treatment of early invasive lung adenocarcinoma: a propensity score matching study |
| title_sort | efficacy of thoracoscopic segmentectomy versus lobectomy in the treatment of early invasive lung adenocarcinoma a propensity score matching study |
| topic | invasive adenocarcinoma of lung segmentectomy lobectomy immunoinflammatory response retrospective analysis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1186991/full |
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