Comparison of sublobar resection and lobectomy for patients with small (≤2cm) second primary non–small‐cell lung cancer

• Published in: Journal of surgical oncology Vol. 122; no. 4; pp. 665 - 674
• Main Authors: Chen, Donglai, Wu, Xuejie, Wen, Junmiao, Xue, Yuhang, Wang, Wenjia, Wang, Yifei, Xue, Tao, Chen, Chang, Chen, Yongbing, Yang, Wentao
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc 01.09.2020
• Subjects: Cancer surgery; Lung cancer; prognosis; second primary lung cancer; surgery; Surgical outcomes
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.26051

Background This study aimed to investigate whether sublobar resection (SR) is equivalent to lobectomy for small (≤ 2 cm) second primary lung cancer (SPLC). Methods We identified 834 patients with T1aN0M0 SPLC from the Surveillance, Epidemiology, and End Results (SEER) database during 2000‐2016. Overall survival (OS) was compared between lobectomy and SR after propensity‐score matching. A total of 228 patients with SPLC were identified from three institutions in China as the validation set. Results SR was an independent risk factor for patients with 1 to 2 cm SPLC (SR vs Lob: hazard ratio [HR], 1.593; 95% confidence interval [CI], 1.186‐2.141; P = .002) but not for patients with SPLC ≤ 1 cm (SR vs Lob: HR, 1.206; 95% CI, 0.790‐1.841; P = .385). Subgroup analysis on the SEER data indicated that OS favored lobectomy compared with SR for contralateral SPLC ≤ 2 cm but not for ipsilateral ones (ipsilateral: P = .692; contralateral: P = .030). Our multi‐institutional data also revealed that SR was equivalent to lobectomy for patients with ≤2 cm ipsilateral SPLC. Conclusions SR is equivalent to lobectomy for SPLC ≤ 1 cm but not for SPLC > 1 to 2 cm. SR might be recommended for patients with ipsilateral small SPLC considering the difficulty in reoperations.