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Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

4141 - Split-lobe resections versus lobectomy for stage IA-IB peripheral non-small cell lung cancer.

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Presenters

Alexandr Levitckii

Citation

Annals of Oncology (2018) 29 (suppl_8): viii483-viii487. 10.1093/annonc/mdy290

Authors

A. Levitckii1, D. Chichevatov2, M. Ter-Ovanesov1, E. Sinev3

Author affiliations

  • 1 Thoracic Oncology, City Clinical Hospital No. 40, 129301 - Moscow/RU
  • 2 Thoracic Oncology, Regional Cancer Center, 440066 - Penza/RU
  • 3 Thoracic Oncology, Regional Cancer Center, Penza/RU
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Abstract 4141

Background

To compare left-upper, right and left inferior split-lobe procedures with the same lobectomies for surgical treatment of peripheral non-small cell lung cancer of stage IA-IB, originating from the large pulmonary lobes.

Methods

We analyzed the results of the treatment of 116 patients, who underwent surgical procedures for clinical stage IA-IB non-small cell lung cancer. Patients were divided into two groups, based on the type of procedure performed. Lobectomies were performed in 78 (67,2%) patients, split-lobe resections of the large pulmonary lobes in 38 (32,8%): upper left trisegmentectomy (S1,2,3) in 14 patients, resection of the lingula (S4,5) in 7, anatomical segmentectomy S6 in 15, resection of basal segments in 2 patients. Radical mediastinal lymph node dissection was performed in all cases. The primary end-points of the analysis were relapse-free survival (RFS), overall survival (OS) and rate of recurrence (RR).

Results

There were no significant differences in morbidity between lobectomy and split-lobe resection groups (7,7% vs. 5,3%; p=NS). RR was registered in 9 patients in the lobectomy group vs 7 patients from split-lobe group (11,5% vs. 18,4%; p=NS). Regional recurrence in hilar lymph nodes was confirmed only in one patient from split-lobe group 28 months after right anatomical segmentectomy S6. Survival analysis did not show significant differences between lobectomy and split-lobe groups. Overall 5-year survival was 82,0% (95% confidence interval, 70,3-93,7%) in lobectomy group versus 74,8% (95% confidence interval, 57,5-97,1%) in split-lobe group (p = 0,369). Relapse-free 5-year survival was 85,2% (95% confidence interval, 76,8-94,6%) in lobectomy group versus 76,2% (95% confidence interval, 59,6-92,8%) in split-lobe group (p = 0,353). Cox regression analysis with multiple factors demonstrated statistical significance for overall (p = 0,03) and relapse-free (p = 0,025) survival only for pT1-T2 tumour descriptors.

Conclusions

Split-lobe procedures and lobectomy have equivalent in-hospital morbidity and long-term results for patients with clinical stage IA-IB peripheral non-small cell LC. In the future split-lobe resection can be recommended as a standard procedure for early stage peripheral non-small cell LC.

Clinical trial identification

Legal entity responsible for the study

City Clinical Hospital no. 40.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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