胸外科英文文献汇报2017.11.23

Results
Two hundred eighty-nine patients met our selection criteria, including WR in 160 and AS in 129. Poor performance status and limited cardiopulmonary reserve were the primary indications for sublobar resection in 76% of WR patients and in 62% of AS patients (p ¼ 0.011). Thirteen patients (4.5%) had pN1/2 disease. Patients undergoing AS were more likely to have nodal sampling/dissection [123 (95%) versus 112 (70%); p < 0.001], more stations sampled (3 versus 2; p < 0.001), and more total nodes resected (7 versus 4; p ¼ 0.001). However, there was no difference between patients undergoing WR versus AS in local recurrence [15 14; p ¼ 0.68] or 5-year DFS (51% versus 53%; p ¼ 0.7; median follow-up 34 months). 研究结果表明，一般状态评分(performance status,PS)不佳、心肺储备有限是亚肺叶切 除的主要适应症，WR组76%患者和AS组62%患者(p=0.011)。13例(4.5%)患者为pN1/2。 AS组与WR组患者的淋巴结采样/切除[123(95%) Vs 112(70%)，p<0.001)，淋巴结站数采样 (3 Vs 2,p< 0.001)，和淋巴结切除(7 Vs 4，p=0.001)比较，两组差异有统计学意义。 然而，AS组与WR组患者的局部复发率(15 Vs 14，p=0.68)和5年DFS(51% Vs 53%， p=0.7，中位随访34个月)均无显著差异。单变量分析显示，切除范围对患者DFS无显著影响， 风险比HR=1.07；95%置信区间0.74-1.56；p=0.696。多因素分析结果表明，肿瘤SUVmax 与DFS呈负相关，HR=1.07；95%置信区间1.01 -1.13；p=0.016。
Conclusions
Our data show that WR and AS are comparable oncologic procedures for carefully staged cT1N0 NSCLC patients. Although AS is associated with a more thorough lymph node dissection, this did not translate to a survival benefit in this patient population with a low rate of nodal metastases. 总之，从上述研究结果看来，针对筛选出分期为cT1N0的NSCLC患者，WR和AS两组患 者的手术疗效无显著差异。在这种淋巴结转移率低的患者群中，尽管AS组较WR组的淋巴结 清扫相对更彻底，但最终没有体现为具体的生存获益。
Results
Univariate analysis showed no effect of extent of resection on DFS[hazard ratio 1.07 (95% confidence interval 0.74–1.56); p ¼ 0.696]. MVA showed that only tumor maximum standardized uptake value was associated with worse DFS [hazard ratio 1.07 (95% confidence interval 1.01–1.13); p ¼ 0.016]. In the propensitymatched analysis of balanced subgroups, there was also no difference (p ¼ 0.950) in 3- or 5-year DFS in cT1N0 patients undergoing WR (65% and 49%) or AS (68% and 49%). PSM分析(n=76)结果显示，AS组与WR组cT1N0患者的3年DFS和5年DFS均没有显著性差异 (p=0.950)，WR组分别为65%和49%，AS组为68%和49%。
Methods
For further comparison of the effect of resection type on survival, propensity score matching (i.e, by age, sex, Charlson comorbidity index（察尔森指数),percent forced expiratory volume in 1 second (FEV1%), clinical tumor size, and tumor maximum standardized uptake value(肿瘤最大标准化摄取值 SUVmax) ,was performed to obtain balanced cohorts of patients undergoing WR and AS (n = 76 per group)
Anatomical Segmentectomy and Wedge Resections Are Associated with Comparable Outcomes for Patients with Small cT1N0 Non–Small Cell Lung Cancer 肺段与肺楔形切除cT1N0 NSCLC对比分析
2017.11.23
Objectives
Sublobar resection(亚肺叶切除) is advocated for patients with NSCLC and compromised cardiopulmonary reserve(心肺功 能储备差), and for selected patients with early stage disease(选 择性早期肺癌患者). Anatomic segmentectomy (AS) has traditionally been considered superior (优于) to wedge resection (WR), but well-balanced comparative studies are lacking. We hypothesize（猜测） that WR and AS are associated with comparable oncologic outcomes for patients with cT1N0 NSCLC.
THAT IS ALL ! THANKS ！
New York Presbyterian Hospital(美国纽约长老会医院) Stiles Байду номын сангаасhorac Oncol
Methods
A retrospective review （回顾性分析）of a prospective database （前瞻性数据库）was performed (2000–2014) for cT1N0 patients, excluding patients with multiple primary tumors, carcinoid tumors,adenocarcinoma in situ, and minimally invasive adenocarcinoma.（多原发肿瘤，类癌，原位腺癌，低侵袭性腺癌） Demographic（人口统计）, clinical, and pathological data were reviewed. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan-Meier method and differences compared using log-rank test（对数秩检验）. Multivariable analysis (MVA) （多变量分析）of factors affecting DFS was performed by Cox regression analysis（考克斯回归分析）.