Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung Adenocarcinoma

Jiaqi Zhang ,* Wenliang Bai ,* Chao Guo, Lei Liu, Guige Wang, Cheng Huang, Yeye Chen, Ye Zhang, Shanqing Li Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People’s Republic of Chin...

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Main Authors: Zhang J, Bai W, Guo C, Liu L, Wang G, Huang C, Chen Y, Zhang Y, Li S
Format: Article
Language:English
Published: Dove Medical Press 2020-10-01
Series:Cancer Management and Research
Subjects:
Online Access:https://www.dovepress.com/postoperative-short-term-outcomes-between-sublobar-resection-and-lobec-peer-reviewed-article-CMAR
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author Zhang J
Bai W
Guo C
Liu L
Wang G
Huang C
Chen Y
Zhang Y
Li S
author_facet Zhang J
Bai W
Guo C
Liu L
Wang G
Huang C
Chen Y
Zhang Y
Li S
author_sort Zhang J
collection DOAJ
description Jiaqi Zhang ,* Wenliang Bai ,* Chao Guo, Lei Liu, Guige Wang, Cheng Huang, Yeye Chen, Ye Zhang, Shanqing Li Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shanqing Li Tel +86 13121971623Fax +86 1069152630Email 13121971623@163.comBackground: To investigate postoperative temporary consequences of the enrolled patients with lung adenocarcinoma.Patients and Methods: We analyzed the clinical data of patients with lung adenocarcinoma admitted by the same surgical team of Peking Union Medical College Hospital (PUMCH) from July 2019 to December 2019. Statistical methods including propensity score matching (PSM) analysis was used to analyze the differences among them.Results: A total of 108 patients were enrolled, including 50 patients with sublobar resection and 58 patients with lobectomy. Before PSM, there were statistically significant differences in age (p=0.015), hospitalization costs (p=0.042), lymphadenectomy (p=0.000), pathological staging (p=0.000), number of lymph nodes removed (p=0.000), number of positive lymph nodes (p=0.034), chest drainage duration (p=0.000), total chest drainage (p=0.000), length of postoperative hospital stays (p=0.000), postoperative D-dimer level (p=0.030) and perioperative lymphocyte margin (LM) (p=0.003) between sublobar resection and lobectomy. After PSM, there were statistical differences in number of lymph nodes removed (p=0.000), chest drainage duration (p=0.031) and total chest drainage (p=0.002) between sublobar resection and lobectomy. Whether with PSM analysis or not, there were no significant differences in other blood test results, such as inflammation indicators, postoperative neutrophil-lymphocyte ratio (NLR), albumin level, perioperative activity of daily living (ADL) scale scoring margin, complications, postoperative admission to intensive care unit (ICU) and readmission within 30 days. NLR was associated with total chest drainage (p=0.000), length of postoperative hospital stays (p=0.000), postoperative D-dimer level (p=0.050) and ADL scale scoring margin (p=0.003) between sublobar resection and lobectomy.Conclusion: Sublobar resection, including wedge resection and segmentectomy, was as safe and feasible as lobectomy in our study, and they shared similar short-term outcomes. Postoperative NLR could be used to detect the clinical outcomes of patients. Secondary resectability of pulmonary function (SRPF) should be the main purpose of sublobar resection.Keywords: lung adenocarcinoma, lobectomy, sublobar resection, short-term outcome
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spelling doaj.art-6f26c93a61a74a1b85acf15e685b35202022-12-22T01:55:53ZengDove Medical PressCancer Management and Research1179-13222020-10-01Volume 129485949357616Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung AdenocarcinomaZhang JBai WGuo CLiu LWang GHuang CChen YZhang YLi SJiaqi Zhang ,* Wenliang Bai ,* Chao Guo, Lei Liu, Guige Wang, Cheng Huang, Yeye Chen, Ye Zhang, Shanqing Li Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shanqing Li Tel +86 13121971623Fax +86 1069152630Email 13121971623@163.comBackground: To investigate postoperative temporary consequences of the enrolled patients with lung adenocarcinoma.Patients and Methods: We analyzed the clinical data of patients with lung adenocarcinoma admitted by the same surgical team of Peking Union Medical College Hospital (PUMCH) from July 2019 to December 2019. Statistical methods including propensity score matching (PSM) analysis was used to analyze the differences among them.Results: A total of 108 patients were enrolled, including 50 patients with sublobar resection and 58 patients with lobectomy. Before PSM, there were statistically significant differences in age (p=0.015), hospitalization costs (p=0.042), lymphadenectomy (p=0.000), pathological staging (p=0.000), number of lymph nodes removed (p=0.000), number of positive lymph nodes (p=0.034), chest drainage duration (p=0.000), total chest drainage (p=0.000), length of postoperative hospital stays (p=0.000), postoperative D-dimer level (p=0.030) and perioperative lymphocyte margin (LM) (p=0.003) between sublobar resection and lobectomy. After PSM, there were statistical differences in number of lymph nodes removed (p=0.000), chest drainage duration (p=0.031) and total chest drainage (p=0.002) between sublobar resection and lobectomy. Whether with PSM analysis or not, there were no significant differences in other blood test results, such as inflammation indicators, postoperative neutrophil-lymphocyte ratio (NLR), albumin level, perioperative activity of daily living (ADL) scale scoring margin, complications, postoperative admission to intensive care unit (ICU) and readmission within 30 days. NLR was associated with total chest drainage (p=0.000), length of postoperative hospital stays (p=0.000), postoperative D-dimer level (p=0.050) and ADL scale scoring margin (p=0.003) between sublobar resection and lobectomy.Conclusion: Sublobar resection, including wedge resection and segmentectomy, was as safe and feasible as lobectomy in our study, and they shared similar short-term outcomes. Postoperative NLR could be used to detect the clinical outcomes of patients. Secondary resectability of pulmonary function (SRPF) should be the main purpose of sublobar resection.Keywords: lung adenocarcinoma, lobectomy, sublobar resection, short-term outcomehttps://www.dovepress.com/postoperative-short-term-outcomes-between-sublobar-resection-and-lobec-peer-reviewed-article-CMARlung adenocarcinomalobectomysublobar resectionshort-term outcome
spellingShingle Zhang J
Bai W
Guo C
Liu L
Wang G
Huang C
Chen Y
Zhang Y
Li S
Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung Adenocarcinoma
Cancer Management and Research
lung adenocarcinoma
lobectomy
sublobar resection
short-term outcome
title Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung Adenocarcinoma
title_full Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung Adenocarcinoma
title_fullStr Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung Adenocarcinoma
title_full_unstemmed Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung Adenocarcinoma
title_short Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung Adenocarcinoma
title_sort postoperative short term outcomes between sublobar resection and lobectomy in patients with lung adenocarcinoma
topic lung adenocarcinoma
lobectomy
sublobar resection
short-term outcome
url https://www.dovepress.com/postoperative-short-term-outcomes-between-sublobar-resection-and-lobec-peer-reviewed-article-CMAR
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