Link to the University of Pittsburgh Homepage
Link to the University Library System Homepage Link to the Contact Us Form

Parenchymal preserving anatomic resections result in less pulmonary function loss in patients with Stage I non-small cell lung cancer

Macke, RA and Schuchert, MJ and Odell, DD and Wilson, DO and Luketich, JD and Landreneau, RJ (2015) Parenchymal preserving anatomic resections result in less pulmonary function loss in patients with Stage I non-small cell lung cancer. Journal of Cardiothoracic Surgery. 1 - 7.

[img]
Preview
PDF
Published Version
Available under License : See the attached license file.

Download (643kB) | Preview
[img] Plain Text (licence)
Available under License : See the attached license file.

Download (1kB)

Abstract

© 2015 Macke et al.; licensee BioMed Central.Background: A suggested benefit of sublobar resection for stage I non-small cell lung cancer (NSCLC) compared to lobectomy is a relative preservation of pulmonary function. Very little objective data exist, however, supporting this supposition. We sought to evaluate the relative impact of both anatomic segmental and lobar resection on pulmonary function in patients with resected clinical stage I NSCLC. Methods: The records of 159 disease-free patients who underwent anatomic segmentectomy (n = 89) and lobectomy (n = 70) for the treatment of stage I NSCLC with pre- and postoperative pulmonary function tests performed between 6 to 36 months after resection were retrospectively reviewed. Changes in forced expiratory volume in one second (FEV<inf>1</inf>) and diffusion capacity of carbon monoxide (DLCO) were analyzed based upon the number of anatomic pulmonary segments removed: 1-2 segments (n = 77) or 3-5 segments (n = 82). Results: Preoperative pulmonary function was worse in the lesser resection cohort (1-2 segments) compared to the greater resection group (3-5 segments) (FEV<inf>1(%predicted)</inf>: 79% vs. 85%, p = 0.038; DLCO<inf>(%predicted)</inf>: 63% vs. 73%, p = 0.010). A greater decline in FEV<inf>1</inf> was noted in patients undergoing resection of 3-5 segments (FEV<inf>1 (observed)</inf>: 0.1 L vs. 0.3 L, p = 0.003; and FEV<inf>1 (% predicted)</inf>: 4.3% vs. 8.2%, p = 0.055). Changes in DLCO followed this same trend (DLCO<inf>(observed)</inf>: 1.3 vs. 2.4 mL/min/mmHg, p = 0.015; and DLCO<inf>(% predicted)</inf>: 3.6% vs. 5.9%, p = 0.280). Conclusions: Parenchymal-sparing resections resulted in better preservation of pulmonary function at a median of one year, suggesting a long-term functional benefit with small anatomic segmental resections (1-2 segments). Prospective studies to evaluate measurable functional changes, as well as quality of life, between segmentectomy and lobectomy with a larger patient cohort appear justified.


Share

Citation/Export:
Social Networking:
Share |

Details

Item Type: Article
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Macke, RA
Schuchert, MJmjs11@pitt.eduMJS11
Odell, DD
Wilson, DOwilsond@pitt.eduWILSOND
Luketich, JDluketich@pitt.eduLUKETICH
Landreneau, RJ
Date: 1 April 2015
Date Type: Publication
Journal or Publication Title: Journal of Cardiothoracic Surgery
Page Range: 1 - 7
DOI or Unique Handle: 10.1186/s13019-015-0253-6
Schools and Programs: School of Medicine > Surgery
Refereed: Yes
Date Deposited: 31 Aug 2016 17:23
Last Modified: 13 Oct 2017 22:55
URI: http://d-scholarship.pitt.edu/id/eprint/29383

Metrics

Monthly Views for the past 3 years

Plum Analytics

Altmetric.com


Actions (login required)

View Item View Item