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The effect of extent of resection on outcomes in patients with limited stage small cell lung cancer.

Publication ,  Conference
Raman, V; Jawitz, OK; Yang, C-FJ; Voigt, SL; D'Amico, TA; Harpole, DH; Tong, BC
Published in: J Thorac Cardiovasc Surg
April 2021

BACKGROUND: There is poor understanding of the comparative effectiveness of lobar and sublobar resections for limited-stage small cell lung cancer (SCLC). We analyzed the National Cancer Database to examine the outcomes of patients undergoing wedge resection (WR), segmentectomy (SR), and lobectomy (LB) for limited-stage SCLC. METHODS: Patients with cT1-2N0M0 SCLC (2004-2015) who underwent definitive surgery were identified and stratified by extent of resection: WR, SR, or LB. The primary outcome was overall survival (OS) and secondary outcomes were margin-positive resection (>R0) and pathologic nodal upstaging. RESULTS: A total 1948 patients met study criteria: 619 (32%) underwent WR, 96 (5%) SR, and 1233 (63%) LB. Patients receiving LB were more likely to be younger, have fewer comorbidities, and be privately insured. The unadjusted 5-year OS of WR, SR, and LB patients was 31% (95% confidence interval [CI], 27-35), 35% (95% CI, 25-49), and 45% (95% CI, 42-49), respectively. In a multivariable Cox model, WR was associated with worse OS (hazard ratio, 1.53; 95% CI, 1.31-1.79) and SR similar OS (hazard ratio, 1.20; 95% CI, 0.87-1.67) compared with LB. SR was associated with similar survival compared with LB in a propensity score-matched multivariable analysis as well. WR was also associated with greater odds of >R0 resection compared with LB. CONCLUSIONS: In this study, patients with limited-stage SCLC undergoing WR experienced worse survival compared with those undergoing LB; survival was similar between segmentectomy and LB.

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Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

April 2021

Volume

161

Issue

4

Start / End Page

1484 / 1492.e5

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Small Cell Lung Carcinoma
  • Retrospective Studies
  • Respiratory System
  • Pneumonectomy
  • Odds Ratio
  • Neoplasm Staging
  • Middle Aged
  • Margins of Excision
 

Citation

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Raman, V., Jawitz, O. K., Yang, C.-F., Voigt, S. L., D’Amico, T. A., Harpole, D. H., & Tong, B. C. (2021). The effect of extent of resection on outcomes in patients with limited stage small cell lung cancer. In J Thorac Cardiovasc Surg (Vol. 161, pp. 1484-1492.e5). United States. https://doi.org/10.1016/j.jtcvs.2020.02.135
Raman, Vignesh, Oliver K. Jawitz, Chi-Fu Jeffrey Yang, Soraya L. Voigt, Thomas A. D’Amico, David H. Harpole, and Betty C. Tong. “The effect of extent of resection on outcomes in patients with limited stage small cell lung cancer.” In J Thorac Cardiovasc Surg, 161:1484-1492.e5, 2021. https://doi.org/10.1016/j.jtcvs.2020.02.135.
Raman V, Jawitz OK, Yang C-FJ, Voigt SL, D’Amico TA, Harpole DH, et al. The effect of extent of resection on outcomes in patients with limited stage small cell lung cancer. In: J Thorac Cardiovasc Surg. 2021. p. 1484-1492.e5.
Raman, Vignesh, et al. “The effect of extent of resection on outcomes in patients with limited stage small cell lung cancer.J Thorac Cardiovasc Surg, vol. 161, no. 4, 2021, pp. 1484-1492.e5. Pubmed, doi:10.1016/j.jtcvs.2020.02.135.
Raman V, Jawitz OK, Yang C-FJ, Voigt SL, D’Amico TA, Harpole DH, Tong BC. The effect of extent of resection on outcomes in patients with limited stage small cell lung cancer. J Thorac Cardiovasc Surg. 2021. p. 1484-1492.e5.

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

April 2021

Volume

161

Issue

4

Start / End Page

1484 / 1492.e5

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Small Cell Lung Carcinoma
  • Retrospective Studies
  • Respiratory System
  • Pneumonectomy
  • Odds Ratio
  • Neoplasm Staging
  • Middle Aged
  • Margins of Excision