RANDOMIZED TRIAL OF LOBECTOMY VERSUS LIMITED RESECTION FOR T1 N0 NON-SMALL-CELL LUNG-CANCER

被引：1684

作者：

HOLMES, CE ^{[1
]}

RUCKDESCHEL, JC ^{[1
]}

JOHNSTON, M ^{[1
]}

THOMAS, PA ^{[1
]}

DESLAURIERS, J ^{[1
]}

GROVER, FL ^{[1
]}

HILL, LD ^{[1
]}

FELD, R ^{[1
]}

GINSBERG, RJ ^{[1
]}

MOUNTAIN, CF ^{[1
]}

DZUIBAN, S ^{[1
]}

KIELY, M ^{[1
]}

MCKNEALLY, MF ^{[1
]}

MOORES, DWO ^{[1
]}

RAMNES, C ^{[1
]}

WAGNER, H ^{[1
]}

BUNN, P ^{[1
]}

CHU, H ^{[1
]}

DIENHART, D ^{[1
]}

HAZUKA, M ^{[1
]}

KINZIE, J ^{[1
]}

SORENSEN, J ^{[1
]}

VANCE, V ^{[1
]}

BRAUN, T ^{[1
]}

HOPEMAN, A ^{[1
]}

KANE, M ^{[1
]}

RUSS, P ^{[1
]}

WHITMAN, GJR ^{[1
]}

FALL, SM ^{[1
]}

HANSEN, DP ^{[1
]}

HENDERSON, RH ^{[1
]}

MONCRIEF, CL ^{[1
]}

PAULING, F ^{[1
]}

SIMS, J ^{[1
]}

TELL, D ^{[1
]}

WISELYCARR, S ^{[1
]}

ABERNATHY, CM ^{[1
]}

CLARK, DA ^{[1
]}

MCCROSKEY, B ^{[1
]}

MOORE, G ^{[1
]}

MOORE, F ^{[1
]}

MYERS, A ^{[1
]}

WHITE, M ^{[1
]}

BROOKS, RJ ^{[1
]}

BULL, M ^{[1
]}

JOHNSON, FB ^{[1
]}

NEIMYR, M ^{[1
]}

PAQUETTE, FR ^{[1
]}

SACCOMANNO, G ^{[1
]}

LAD, T ^{[1
]}

机构：

[1] MEM SLOAN KETTERING CANC CTR, DEPT SURG, THORAC SERV, NEW YORK, NY 10021 USA

来源：

ANNALS OF THORACIC SURGERY | 1995年 / 60卷 / 03期

关键词：

D O I：

10.1016/0003-4975(95)00537-u

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background. It has been reported that limited resection (segment or wedge) is equivalent to lobectomy in the management of early stage (T1-2 NO) non-small cell lung cancer. Methods. A prospective, multiinstitutional randomized trial was instituted comparing limited resection with lobectomy for patients with peripheral TI NO non-small cell lung cancer documented at operation. Analysis included locoregional and distant recurrence rates, 5-year survival rates, perioperative morbidity and mortality, and late pulmonary function assessment. Results. There were 276 patients randomized, with 247 patients eligible for analysis. There were no significant differences for all stratification variables, selected prognostic factors, perioperative morbidity, mortality, or late pulmonary function. In patients undergoing limited resection, there was an observed 75% increase in recurrence rates (p = 0.02, one-sided) attributable to an observed tripling of the local recurrence rate (p = 0.008 two-sided), an observed 30% increase in overall death rate (p = 0.08, one-sided), and an observed 50% increase in death with cancer rate (p = 0.09, one-sided) compared to patients undergoing lobectomy (p = 0.10, one-sided was the predefined threshold for statistical significance for this equivalency study). Conclusions. Compared with lobectomy, limited pulmonary resection does not confer improved perioperative morbidity, mortality, or late postoperative pulmonary function. Because of the higher death rate and locoregional recurrence rate associated with limited resection, lobectomy still must be considered the surgical procedure of choice for patients with peripheral T1 NO nonsmall cell lung cancer.

引用

页码：615 / 622

页数：8

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