Resultados de la resección pulmonar infralobar, comparada con la lobectomía, en el tratamiento quirúrgico del carcinoma broncogénico en estadio precoz / Outcomes of sublobar resection, compared with lobectomy, in the surgical management of early stage non-small cell lung cancer
Rev. esp. patol. torac
; 28(3): 174-187, mayo 2016. tab, graf
Article
in Spanish
| IBECS
| ID: ibc-152951
Responsible library:
ES1.1
Localization: BNCS
RESUMEN
OBJETIVOS:
la resección infralobar (RI) en el carcinoma broncogénico de célula no pequeña (CBCNP) en estadio precoz está ganando popularidad. Sin embargo, la cantidad óptima de parénquima pulmonar a resecar sigue siendo objeto de controversia. Analizamos si la RI difiere de la lobectomía (L) como tratamiento quirúrgico estándar de los pacientes con CBCNP en estadio precoz.MÉTODOS:
se analizaron 493 resecciones pulmonares consecutivas realizadas en un periodo de 14 años. 266 pacientes con CBCNP en estadio I fueron sometidos a una lobectomía (L = 178), o a una resección pulmonar atípica/segmentectomía (RI = 88). Se compararon factores demográficos, oncológicos, quirúrgicos y postoperatorios.RESULTADOS:
no se observaron diferencias en las características de los pacientes, la mortalidad perioperatoria o la tasa de complicaciones. En los pacientes con CBCNP en estadio I (n = 266) la tasa de recurrencia loco-regional (RI vs L) 14% vs 16% (p = 0,06), metástasis a distancia 8% vs 9% (p = 0,33), supervivencia (a los 3, 5 años) 78%, 74% vs 74%, 69% (p = 0,37), supervivencia libre de enfermedad (a los 3, 5 años) 82%, 36% vs 80%, 56% (p = 0,93), supervivencia libre de metástasis a distancia (a los 3, 5 años) 90%, 80% vs 86%, 83% (p = 0,73). Complicaciones postquirúrgicas 30% vs 36% (p = 0,21), mortalidad perioperatoria 2% vs 5% (p = 0,64).CONCLUSIONES:
la resección pulmonar infralobar posee unas tasas aceptables de morbimortalidad y puede ser equivalente a la lobectomía, desde el punto de vista oncológico, en el CBCNP en estadio IABSTRACT
OBJECTIVE:
sublobar resection (SLR) for early stage NSCLC is gaining acceptance in the recent years, especially in aging population or with decreased pulmonary function. The optimal extent of surgical resection in stage I NSCLC remains controversial. This study was designed to determine whether SLR differs from lobectomy (L) as the standard of care for the surgical treatment of patients with early stage NSCLC.METHODS:
we retrospectively reviewed 493 consecutive lung resections performed over a 5-year period at a single center. A total of 266 patients with NSCLC underwent either lobectomy (L Group 178 patients), or wedge/segmentectomy (SLR Group 88 patients) for stage I NSCLC. Demographic, oncological, surgical and postoperative variables were compared between groups.RESULTS:
overall, no differences were observed between SLR and L in patient characteristics, 30-day mortality and complications. In stage I patients (n = 266), local recurrence (SLR vs L) 14% vs 16% (p = .06), distant recurrence 8% vs 9% (p = .33), survival (at 3, 5 years) 78%, 74% vs 74%, 69% (p = .37), local disease-free survival (at 3, 5 years) 82%, 36% vs 80%, 56% (p = .93), distant disease-free survival (at 3, 5 years) 90%, 80% vs 86%, 83% (p = .73). Postoperative complications 30% vs 36% (p = .21), 30-day mortality 2% vs 5% (p = .64).CONCLUSION:
sublobar resection has acceptable morbidity and mortality rates, and could be oncologically equivalent to lobectomy in stage I NSCLC
Full text:
Available
Collection:
National databases
/
Spain
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Other Respiratory Diseases
/
Trachea, Bronchus, Lung Cancers
Database:
IBECS
Main subject:
Carcinoma, Bronchogenic
/
Carcinoma, Non-Small-Cell Lung
/
Lung Neoplasms
Limits:
Humans
Language:
Spanish
Journal:
Rev. esp. patol. torac
Year:
2016
Document type:
Article
Institution/Affiliation country:
Hospital Universitario Reina Sofía/España