Extent of lymphadenectomy is associated with oncological efficacy of sublobar resection for lung cancer ≤2 cm Brendon M. Stiles, MD, Jialin Mao, MD,

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Presentation transcript:

Extent of lymphadenectomy is associated with oncological efficacy of sublobar resection for lung cancer ≤2 cm Brendon M. Stiles, MD, Jialin Mao, MD, Sebron Harrison, MD, Benjamin Lee, MD, Jeffrey L. Port, MD, Art Sedrakyan, MD, Nasser K. Altorki, MD The Journal of Thoracic and Cardiovascular Surgery Volume 157, Issue 6, Pages 2454-2465.e1 (June 2019) DOI: 10.1016/j.jtcvs.2019.01.136 Copyright © 2019 Terms and Conditions

Figure 1 Identification of patients for inclusion from the Surveillance, Epidemiology and End Results Program-Medicare database between 2007 and 2012. SLR, Sublobar resection. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2454-2465.e1DOI: (10.1016/j.jtcvs.2019.01.136) Copyright © 2019 Terms and Conditions

Figure 2 Survival increased with increasing numbers of lymph nodes examined. Using node counts as cutpoints and piecewise cox regression, a cutpoint of 9 was selected as the most discriminatory based on the lowest Akaike information criterion. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2454-2465.e1DOI: (10.1016/j.jtcvs.2019.01.136) Copyright © 2019 Terms and Conditions

Figure 3 Overall survival and cancer-specific survival following lobectomy and sublobar resection (SLR) for lung cancer with tumor size ≤2 cm among Medicare beneficiaries. A and B, Before propensity-score matching. C and D, After propensity-score matching. Matching conducted without considering lymph nodes examined. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2454-2465.e1DOI: (10.1016/j.jtcvs.2019.01.136) Copyright © 2019 Terms and Conditions

Figure 4 Subgroup analysis of overall survival and cancer-specific survival following lobectomy and sublobar resection (SLR) for lung cancer with tumor size ≤2 cm among Medicare beneficiaries after propensity-score matching. A and B, Patients with at least 1 lymph node examined. C and D, Patients with at least 9 lymph nodes examined. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2454-2465.e1DOI: (10.1016/j.jtcvs.2019.01.136) Copyright © 2019 Terms and Conditions

After matching, survival of sublobar resection (red) is equivalent to lobectomy (blue). The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2454-2465.e1DOI: (10.1016/j.jtcvs.2019.01.136) Copyright © 2019 Terms and Conditions

The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2454-2465 The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2454-2465.e1DOI: (10.1016/j.jtcvs.2019.01.136) Copyright © 2019 Terms and Conditions