Local Extension at the Hilum Region Is Associated With Worse Long-Term Survival in Stage I Non-Small Cell Lung Cancers Chang Chen, MD, Fang Bao, MD,

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Local Extension at the Hilum Region Is Associated With Worse Long-Term Survival in Stage I Non-Small Cell Lung Cancers Chang Chen, MD, Fang Bao, MD, Hui Zheng, MD, Yi-ming Zhou, MD, Min-wei Bao, MD, Hui-kang Xie, MD, Ge-ning Jiang, MD, Jia-an Ding, MD, Wen Gao, MD The Annals of Thoracic Surgery Volume 93, Issue 2, Pages 389-396 (February 2012) DOI: 10.1016/j.athoracsur.2011.09.079 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 All cases were assigned to the four study groups—L (lobectomies), B (bronchoplasties), A (angioplasties), and BA (bronchoangioplasties)—according to the different hilar structure involvement. (A) Standard lobectomy was performed for group L, (B) bronchoplastic or sleeve bronchial resections for group B; (C) pulmonary angioplastic procedure for group A; and (D) bronchial sleeve resection combined with angioplastic or sleeve vessel resections for group BA. A plus sign (+) indicates tumor lobar orifice involvement; a minus sign (−) indicates no lobar orifice involvement. (PA = pulmonary artery.) The Annals of Thoracic Surgery 2012 93, 389-396DOI: (10.1016/j.athoracsur.2011.09.079) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Case distributions according to subgroups—L (lobectomies), B (bronchoplasties), A (angioplasties), and BA (bronchoangioplasties)—and tumor site. A plus sign (+) indicates tumor lobar orifice involvement; a minus sign (−) indicates no bronchial extension. (LL = left lower lobe; LU = left upper lobe; PA = pulmonary artery; RL = right lower lobe; RM = right middle lobe; RU = right upper lobe.) The Annals of Thoracic Surgery 2012 93, 389-396DOI: (10.1016/j.athoracsur.2011.09.079) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 The survival rates of the four study groups—L (lobectomies [heavy dotted line]), B (bronchoplasties [light solid line]), A (angioplasties [light dotted line]), and BA (bronchoangioplasties [heavy solid line])—were obvious at three grades, with group B and group A being the intermediate. There was no significant difference of survival between group B and group A (p = 0.948). Pairwise comparisons revealed a significant difference in survival rate between group L and group B (p = 0.036), group L and group A (p = 0.047), group B and BA (p = 0.008), and group A and BA (p = 0.048). The Annals of Thoracic Surgery 2012 93, 389-396DOI: (10.1016/j.athoracsur.2011.09.079) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Kaplan-Meier survival curves between group L (lobectomies [broken line]) and groups B (bronchoplasties) + A (angioplasties) + BA (bronchoangioplasties [solid line]). The Annals of Thoracic Surgery 2012 93, 389-396DOI: (10.1016/j.athoracsur.2011.09.079) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 (A) Survival rates were prominently different between cases with major pulmonary artery (PA) invasion (solid line) and cases without major PA invasion (broken line) by comparing groups A (angioplasties) and BA (bronchoangioplasties) versus groups L (lobectomies) and B (bronchoplasties). (B) There was also a prominent survival difference between cases with bronchial invasion (solid line) and cases without bronchial tumor extension (broken line), by comparing groups B and BA versus groups L and A. The Annals of Thoracic Surgery 2012 93, 389-396DOI: (10.1016/j.athoracsur.2011.09.079) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Kaplan-Meier survival curves according to tumor size: ≤2 cm (light dotted line), 2.01 to 3 cm (heavy dotted line); and 3.01 cm to 5 cm (solid line [log rank p = 0.008]). The Annals of Thoracic Surgery 2012 93, 389-396DOI: (10.1016/j.athoracsur.2011.09.079) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions