{"id":23510,"date":"2023-03-19T04:24:00","date_gmt":"2023-03-18T20:24:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=23510"},"modified":"2023-03-22T00:07:53","modified_gmt":"2023-03-21T16:07:53","slug":"%e5%91%a8%e5%9b%b4%e5%9e%8bia%e6%9c%9f%e9%9d%9e%e5%b0%8f%e7%bb%86%e8%83%9e%e8%82%ba%e7%99%8c%e7%9a%84%e8%82%ba%e5%8f%b6%e6%88%96%e4%ba%9a%e8%82%ba%e5%8f%b6%e5%88%87%e9%99%a4","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=23510","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u5468\u56f4\u578bIA\u671f\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u7684\u80ba\u53f6\u6216\u4e9a\u80ba\u53f6\u5207\u9664"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Lobar or Sublobar Resection for Peripheral Stage IA Non\u2013Small-Cell Lung Cancer<\/h1>\n\n\n\n

Nasser Altorki, Xiaofei Wang, David Kozono, et al<\/h3>\n\n\n\n

N Engl J Med 2023; 388:489-498
DOI: 10.1056\/NEJMoa2212083<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h2>\n\n\n\n

The increased detection of small-sized peripheral non\u2013small-cell lung cancer (NSCLC) has renewed interest in sublobar resection in lieu of lobectomy.<\/p>\n\n\n\n

METHODS<\/h2>\n\n\n\n

We conducted a multicenter, noninferiority, phase 3 trial in which patients with NSCLC clinically staged as T1aN0 (tumor size, \u22642 cm) were randomly assigned to undergo sublobar resection or lobar resection after intraoperative confirmation of node-negative disease. The primary end point was disease-free survival, defined as the time between randomization and disease recurrence or death from any cause. Secondary end points were overall survival, locoregional and systemic recurrence, and pulmonary functions.<\/a><\/p>\n\n\n\n

RESULTS<\/h2>\n\n\n\n

From June 2007 through March 2017, a total of 697 patients were assigned to undergo sublobar resection (340 patients) or lobar resection (357 patients). After a median follow-up of 7 years, sublobar resection was noninferior to lobar resection for disease-free survival (hazard ratio for disease recurrence or death, 1.01; 90% confidence interval [CI], 0.83 to 1.24). In addition, overall survival after sublobar resection was similar to that after lobar resection (hazard ratio for death, 0.95; 95% CI, 0.72 to 1.26). The 5-year disease-free survival was 63.6% (95% CI, 57.9 to 68.8) after sublobar resection and 64.1% (95% CI, 58.5 to 69.0) after lobar resection. The 5-year overall survival was 80.3% (95% CI, 75.5 to 84.3) after sublobar resection and 78.9% (95% CI, 74.1 to 82.9) after lobar resection. No substantial difference was seen between the two groups in the incidence of locoregional or distant recurrence. At 6 months postoperatively, a between-group difference of 2 percentage points was measured in the median percentage of predicted forced expiratory volume in 1 second, favoring the sublobar-resection group.<\/p>\n\n\n\n

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CONCLUSIONS<\/h2>\n\n\n\n

In patients with peripheral NSCLC with a tumor size of 2 cm or less and pathologically confirmed node-negative disease in the hilar and mediastinal lymph nodes, sublobar resection was not inferior to lobectomy with respect to disease-free survival. Overall survival was similar with the two procedures. (Funded by the National Cancer Institute and others; CALGB 140503 ClinicalTrials.gov number, NCT00499330. opens in new tab<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Lobar or Sublobar Resection for Periph […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23510"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23510"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23510\/revisions"}],"predecessor-version":[{"id":23754,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23510\/revisions\/23754"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23510"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23510"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23510"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}