초록접수 현황
| 20F-219 | 구연 발표 |
Video-Assisted Thoracic Surgery Sublobar Resection may be a Reasonable Alternative for Lung Cancer in Patients with Poor Lung Function
Yun Ho Jeon, Jae Hwa Jeong, Jae Kwang Yun, Yong Ho Jeong, Geun Dong Lee, Sehoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Purpose : DLCO and FEV1 are important indicator in determining extent of surgery in lung cancer. VATS has made patients with low PFT to be performed surgery. However, it is still burdensome for surgeon to perform a lobar resection. Therefore, sublobar resection can be performed considering complications and the quality of life. So, we tried to find the value of FEV1 and DLCO that sublobar resection can be considered reasonable in VATS.
Methods : We retrospectively reviewed patients with FEV1 or DLCO ≤ 80%, lobar or sublobar resection, and pathologic stage I to IIA from 2006 to 2017. We tried to find out the FEV1 and DLCO values at which the difference in survival rates between sublobar and lobar resection disappeared. Then, by dividing the Lobar resection group based on the value, we tried to find out which variables had significant differences.
Results : the DLCO≤55%, Kaplan-Meier curve analysis showed the significant difference in survival rate disappeared between the two groups of sublobar and lobar resection.(P=0.172) In the lobar resection group, when comparing patients with DLCO≤55% and >55%, the incidence of postoperative pneumonia (P=0.021) and 30-day mortality (P<0.001) significantly increased in patients with DLCO≤55%. Logistic regression analysis showed that postoperative pneumonia was strongly associated with age [OR 1.143, P=0.008] and DLCO [OR 0.937, P=0.024] in lobar resection group with DLCO≤80%
Conclusion : In stage I to IIA lung cancer patients with in DLCO≤55%, VATS lobar resection needs to be carefully performed and VATS sublobar resection can be considered as a reasonable alternative.
Methods : We retrospectively reviewed patients with FEV1 or DLCO ≤ 80%, lobar or sublobar resection, and pathologic stage I to IIA from 2006 to 2017. We tried to find out the FEV1 and DLCO values at which the difference in survival rates between sublobar and lobar resection disappeared. Then, by dividing the Lobar resection group based on the value, we tried to find out which variables had significant differences.
Results : the DLCO≤55%, Kaplan-Meier curve analysis showed the significant difference in survival rate disappeared between the two groups of sublobar and lobar resection.(P=0.172) In the lobar resection group, when comparing patients with DLCO≤55% and >55%, the incidence of postoperative pneumonia (P=0.021) and 30-day mortality (P<0.001) significantly increased in patients with DLCO≤55%. Logistic regression analysis showed that postoperative pneumonia was strongly associated with age [OR 1.143, P=0.008] and DLCO [OR 0.937, P=0.024] in lobar resection group with DLCO≤80%
Conclusion : In stage I to IIA lung cancer patients with in DLCO≤55%, VATS lobar resection needs to be carefully performed and VATS sublobar resection can be considered as a reasonable alternative.
첨부파일 : Tables and Figure.docx
책임저자: Geun Dong Lee
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
발표자: Yun Ho Jeon, E-mail : yunja0129@naver.com