Sublobectomy versus lobectomy for stage I non-small cell lung cancer in the elderly.
OBJECTIVE
The aim of our study was to compare the operative characteristics and long term survival for elderly patients with stage I non-small cell lung cancer (NSCLC) who underwent sublobectomy versus lobectomy.


METHODS
We identified 245 consecutive elderly patients (≥65y) with pathologic stage I NSCLC who underwent lobectomy or sublobectomy at our institution between 2006 and 2012, and assessed the operative characteristics, recurrence, and survival differences between these approaches.


RESULTS
A total of 39 patients underwent sublobectomy and 206 patients had lobectomy. There were significantly more COPD (p = 0.046) and low percent of predicted FEV1 (p = 0.034) in sublobectomy patients compared to the lobectomy group. Sublobectomy patients had significantly shorter operating time (p = 0.001), less blood loss (p = 0.000), and trended toward fewer chest tube days (p = 0.001) and shorter hospital length of stay (p = 0.030). The 1-, 3-, and 5-year survival rates in patients with lobectomy were 91.3, 77.7, and 64.1%, respectively, and has no significantly difference with those underwent sublobectomy (87.2, 74.4, and 61.5%, respectively, p = 0.623). Subgroups survival analysis showed no significant difference in the OS and DFS for patients with T < 2 cm or %FEV1<80%, but survival after sublobectomy was worse if performed on patients with larger tumours (T ≥ 2 cm) or relatively strong lung function (%FEV1≥80%).


CONCLUSION
We concluded that sublobectomy might achieve similar survival rates when compared with lobectomy in elderly stage I NSCLC patients, especially for patients with low %FEV1 and stage IA tumours less than 2 cm in diameter.
['Qiu|Chen|C|', 'Wang|Guanghui|G|', 'Xu|Jun|J|', 'Cui|Lixuan|L|', 'Dong|Wei|W|', 'Ni|Yang|Y|', 'Qu|Xiao|X|', 'Du|Jiajun|J|']
D000368:Aged D016063:Blood Loss, Surgical D002289:Carcinoma, Non-Small-Cell Lung D005260:Female D005541:Forced Expiratory Volume D006801:Humans D007902:Length of Stay D008175:Lung Neoplasms D008297:Male D061646:Operative Time D011013:Pneumonectomy D012189:Retrospective Studies
Lobectomy Elderly NSCLC Segmentectomy Wedge resection