1. Comparison of short and long-term results between sleeve resection and pneumonectomy in lung cancer patients over 70 years old: 10 years experience from a single institution in China.
- Author
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Pan, Xufeng, Tantai, Jicheng, Lin, Ling, Cao, Kejian, and Zhao, Heng
- Subjects
PNEUMONECTOMY ,DIAGNOSIS of diabetes ,MEDICAL care ,CANCER patients ,CHEST tumors ,CHI-squared test ,CORONARY disease ,FISHER exact test ,LUNG tumors ,PATIENTS ,PREOPERATIVE care ,PULMONARY function tests ,SMOKING ,OPERATIVE surgery ,SURVIVAL ,COMORBIDITY ,DATA analysis ,VITAL capacity (Respiration) ,KAPLAN-Meier estimator ,DIAGNOSIS - Abstract
Background The aim of this study was to compare the short and long-term results between sleeve resection ( SR) and pneumonectomy ( PN) in lung cancer patients over 70 years of age. Methods We retrospectively reviewed 105 lung cancer patients over 70 years of age who had undergone SR or PN at Shanghai Chest Hospital from January 2003 to December 2012. Results The SR group showed a higher frequency of airway clearance via bronchoscopy (48.6% vs. 25.7%, P = 0.04), longer surgical time (162.7 vs. 140.9 minutes, P = 0.01), and shorter postoperative stay (13.7 vs. 18.1 days, P = 0.02) than the PN group. There was no difference in hospital mortality ( P = 1.00) or morbidity ( P = 0.40) between the two groups. A logistic regression model showed that preoperative predicted forced expiratory volume in 1 second was the only independent risk factor for overall morbidity ( P = 0.04). In survival analysis, SR showed better prognosis than PN (median 50.0 vs. 20.0 months, P < 0.01). In subgroup analysis, SR showed better survival in N0 ( P = 0.03) and N1 ( P < 0.01) cases, but not in N2 cases ( P = 0.36). It also showed better survival in stage I + II patients ( P = 0.03), but not in stage III patients ( P = 0.10). Conclusions Although PN could be carried out as safely as SR in patients over 70 years of age with a good pulmonary reservoir, SR is still recommended as a less traumatic procedure, sparing lung parenchyma with better long-term results. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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