CTR > 0.7 predicts the subgroup of lung adenocarcinomas ≤ 2 cm at risk of poor outcome treated by sublobar resection compared to lobar resection

作者全名：Jing, Weiwei; Li, Qi; Liu, Mengxi; Zhang, Yi; Chen, Sifan; Zhang, Ke; Li, Dan; Zhao, Min; Zheng, Yineng; Li, Wangjia; Wu, Yangying; Xu, Hongbo; Zhao, Ziya; Kang, Shaolei; Lv, Fajin

作者地址：[Jing, Weiwei; Li, Qi; Liu, Mengxi; Chen, Sifan; Zhang, Ke; Zheng, Yineng; Li, Wangjia; Wu, Yangying; Xu, Hongbo; Zhao, Ziya; Lv, Fajin] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, 1 Youyi Rd, Chongqing 400016, Peoples R China; [Zhang, Yi] Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Clin Res Ctr Canc, Dept Pathol,Natl Canc Ctr, Beijing 100021, Peoples R China; [Li, Dan; Zhao, Min] Chongqing Med Univ, Affiliated Hosp 1, Dept Pathol, Chongqing, Peoples R China; [Kang, Shaolei] Kunming Med Univ, Affiliated Hosp 1, Dept Radiol, 295 Xichang Rd, Kunming 650032, Peoples R China

通信作者：Lv, FJ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, 1 Youyi Rd, Chongqing 400016, Peoples R China.

来源：CANCER IMAGING

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001249678200003

JCR分区：Q1

影响因子：3.5

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Lung adenocarcinoma; 2 cm; CTR; Surgical approach; Prognosis

摘要：Background A standard surgical procedure for patients with small early-stage lung adenocarcinomas remains unknown. Hence, we aim in this study to assess the clinical utility of the consolidation-to-tumor ratio (CTR) when treating patients with small (2 cm) early stage lung cancers. Methods A retrospective cohort of 298 sublobar resection and 266 lobar resection recipients for early stage lung adenocarcinoma <= 2 cm was assembled from the First Affiliated Hospital of Chongqing Medical University between 2016 and 2019. To compare survival rates among the different groups, Kaplan-Meier curves were calculated, and the log-rank test was used. A multivariate Cox proportional hazard model was constructed utilizing variables that were significant in univariate analysis of survival. Results In the study, 564 patients were included, with 298 patients (52.8%) undergoing sublobar resection and 266 patients (47.2%) undergoing lobar resection. Regarding survival results, there was no significant difference in the 5-year overall survival (OS, P = 0.674) and 5-year recurrence-free survival (RFS, P = 0.253) between the two groups. Cox regression analyses showed that CTR >= 0.75(P < 0.001), age > 56 years (P = 0.007), and sublobar resection(P = 0.001) could predict worse survival. After examining survival results based on CTR categorization, we segmented the individuals into three categories: CTR<0.7, 0.7 <= CTR<1, and CTR = 1.The lobar resection groups had more favorable clinical outcomes than the sublobar resection groups in both the 0.7 <= CTR < 1(RFS: P < 0.001, OS: P = 0.001) and CTR = 1(RFS: P = 0.001, OS: P = 0.125). However, for patients with 0 <= CTR < 0.7, no difference in either RFS or OS was found between the lobar resection and sublobar resection groups, all of which had no positive events. Patients with a CTR between 0.7 and 1 who underwent lobar resection had similar 5-year RFS and OS rates compared to those with a CTR between 0 and 0.7 who underwent sublobar resection (100% vs. 100%). Nevertheless, a CTR of 1 following lobar resection resulted in notably reduced RFS and OS when compared to a CTR between 0.7 and 1 following lobar resection (P = 0.005 and P = 0.016, respectively). Conclusion Lobar resection is associated with better long-term survival outcomes than sublobar resection for small lung adenocarcinomas <= 2 cm and CTR >= 0.7.

基金机构：First-Class Discipline Construction Project of The First Affiliated Hospital of Chongqing Medical University

基金资助正文：Not applicable.