LONG TERM FOLLOW-UP IN SURGICAL STAGE I NON-SMALL CELL LUNG CANCER – A SINGLE CENTER EXPERIENCE

Authors

  • Carolina Dantas Pulmonology department, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • Sara Campos Silva Pulmonology department, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • David Tavares Silva Pulmonology department, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • João Santos Silva Thoracic Surgery department, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • Ana Rita Costa Thoracic Surgery department, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • João Eurico Reis Paulo Calvinho Thoracic Surgery department, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal

DOI:

https://doi.org/10.48729/pjctvs.165

Abstract

Introduction: Lung cancer has a high mortality rate with an overall survival of 18% at 5 years. Surgical treatment is the gold standard for early stages and is associated with high rates of resolution with a 5-year survival of 80% reported in large studies.

Purpose: To determinethe survival of patients with non-small cell lung cancer (NSCLC) in stage IA (T1N0M0) undergoing surgical treatment with curative intent in our center.

Methods: We performed a retrospective review of the clinical records of all patients with pathological stage T1a-c N0 (stage I) who underwent thoracic surgery with curative intent from 2010 and 2017 in our center. Overall survival and lung cancer-specific survival was estimated by the Kaplan-Meier method.

Results: 87 patients (54 men and 33 women) with a median age of 66 years (range 36 to 83 years) were included. Lobectomy with systematic lymph node dissection was performed in 67 patients (77%). Adenocarcinoma was the predominant histological subtype (n=69; 79%). Overall survival at 5th years was 86,7%. Patients submitted to limited resection (segmentectomy or wedge resection) had lower overall survival compared to those submitted to lobectomy (66,4% vs 88,7%; p=0.008).

Conclusions: Our results show a high 5-year overall survival rate, in agreement with results from larger series studies. Lung cancer screening, although not yet widely implemented, has been shown to reduce mortality associated with lung cancer. These results reinforce the importance of screening programs for specific populations in order to identify patients in early stages and improve overall survival.

Downloads

Download data is not yet available.

References

Planchard D, Popat S, Kerr K et al. Metastatic non-small cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29 Suppl 4:iv192-iv237.

Reck M, Popat S, Reinmuth N et al. Metastatic nonsmall-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25 Suppl 3:iii27-39.

Kauczor HU, Baird AM, Blum TG et al. ESR/ERS statement paper on lung cancer screening. Eur Respir J. 2020;55

Deffebach M HL. Screening for lung cancer - in Uptodate.

Detterbeck FC, Boffa DJ, Kim AW, Tanoue LT. The Eighth Edition Lung Cancer Stage Classification. Chest.

;151:193-203.

Ettinger DS, Aisner DL, Wood DE et al. NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 5.2018. J Natl Compr Canc Netw. 2018;16:807-821.

McDonald F, De Waele M, Hendriks LE, Faivre-Finn C, Dingemans AC, Van Schil PE. Management of stage I

and II nonsmall cell lung cancer. Eur Respir J. 2017;49

Raz DJ, Zell JA, Ou SH, Gandara DR, Anton-Culver H, Jablons DM. Natural history of stage I non-small cell

lung cancer: implications for early detection. Chest. 2007;132:193-199.

Lu T, Yang X, Huang Y et al. Trends in the incidence, treatment, and survival of patients with lung cancer in the last four decades. Cancer Manag Res. 2019;11:943-953.

Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg. 1995;60:615-22; discussion 622.

Cao C, Gupta S, Chandrakumar D, Tian DH, Black D, Yan TD. Meta-analysis of intentional sublobar resections versus lobectomy for early stage non-small cell lung cancer. Ann Cardiothorac Surg. 2014;3:134-141.

Hamatake D, Yoshida Y, Miyahara S, Yamashita S, Shiraishi T, Iwasaki A. Surgical outcomes of lung cancer measuring less than 1 cm in diameter. Interact Cardiovasc Thorac Surg. 2012;15:854-858.

Ichiki Y, Hanagiri T, Baba T et al. Limited pulmonary resection for peripheral small-sized adenocarcinoma of the lung. Int J Surg. 2011;9:155-159.

Koike T, Yamato Y, Yoshiya K, Shimoyama T, Suzuki R. Intentional limited pulmonary resection for peripheral T1 N0 M0 small-sized lung cancer. J Thorac Cardiovasc Surg. 2003;125:924-928.

Okada M, Koike T, Higashiyama M, Yamato Y, Kodama K, Tsubota N. Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg. 2006;132:769-775.

Yano M, Yoshida J, Koike T et al. Survival of 1737 lobectomy-tolerable patients who underwent limited resection for cStage IA non-small-cell lung cancer. Eur J Cardiothorac Surg. 2015;47:135-142.

Altorki NK, Wang X, Wigle D et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: posthoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med. 2018;6:915-924.

Nakamura K, Saji H, Nakajima R et al. A phase III randomized trial of lobectomy versus limited resection for smallsized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). Jpn J Clin Oncol. 2010;40:271-274.

Ezer N, Kale M, Sigel K et al. Outcomes after Video-assisted Thoracoscopic Lobectomy versus Open Lobectomy for Early-Stage Lung Cancer in Older Adults. Ann Am Thorac Soc. 2018;15:76-82.

Long H, Tan Q, Luo Q et al. Thoracoscopic Surgery Versus Thoracotomy for Lung Cancer: Short-Term Outcomes of a Randomized Trial. Ann Thorac Surg. 2018;105:386-392.

Cai YX, Fu XN, Xu QZ, Sun W, Zhang N. Thoracoscopic lobectomy versus open lobectomy in stage I non-small cell lung cancer: a meta-analysis. PLoSOne. 2013;8:e82366.

de Koning HJ, van der Aalst CM, de Jong PA et al. Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial. N Engl J Med. 2020;382:503-513.

National LSTRT, Aberle DR, Adams AM et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365:395-409.

Downloads

Published

02-07-2021

How to Cite

1.
Dantas C, Campos Silva S, Tavares Silva D, Santos Silva J, Costa AR, Reis Paulo Calvinho JE. LONG TERM FOLLOW-UP IN SURGICAL STAGE I NON-SMALL CELL LUNG CANCER – A SINGLE CENTER EXPERIENCE. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 Jul. 2 [cited 2024 Dec. 21];28(2):23-7. Available from: https://pjctvs.com/index.php/journal/article/view/165

Issue

Section

Original Articles

Most read articles by the same author(s)