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

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Abstract
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.
Funding Information
  • Shanghai Municipal Hospital Development Center (SHDC12015116)
  • National Natural Science Foundation of China (NSFC81770091)

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