Advanced

Lobectomy for non-small cell lung carcinoma : a nationwide study of short- and long-term survival

Oskarsdottir, G. N. LU ; Halldorsson, H.; Sigurdsson, M. I.; Fridriksson, B. M.; Baldvinsson, K.; Orrason, A. W.; Jonsson, S. LU ; Planck, M. LU and Gudbjartsson, T (2017) In Acta Oncologica 56. p.936-942
Abstract

Introduction: Lobectomy is the standard curative treatment for non-small cell carcinoma (NSCLC) of the lung. Most studies on lobectomy have focused on short-term outcome and 30-day mortality. The aim of this study was to determine both short-term and long-term surgical outcome in all patients who underwent lobectomy for NSCLC in Iceland over a 24-year period. Material and methods: The study involved 489 consecutive patients with NSCLC who underwent lobectomy with curative intent in Iceland, 1991–2014. Patient demographics, pTNM stage, rate of perioperative complications, and 30-day mortality were registered. Overall survival was analyzed with the Kaplan?Meier method. The Cox proportional hazards model was used to evaluate factors that... (More)

Introduction: Lobectomy is the standard curative treatment for non-small cell carcinoma (NSCLC) of the lung. Most studies on lobectomy have focused on short-term outcome and 30-day mortality. The aim of this study was to determine both short-term and long-term surgical outcome in all patients who underwent lobectomy for NSCLC in Iceland over a 24-year period. Material and methods: The study involved 489 consecutive patients with NSCLC who underwent lobectomy with curative intent in Iceland, 1991–2014. Patient demographics, pTNM stage, rate of perioperative complications, and 30-day mortality were registered. Overall survival was analyzed with the Kaplan?Meier method. The Cox proportional hazards model was used to evaluate factors that were prognostic of overall mortality. To study trends in survival, the study period was divided into six 4-year periods. The median follow-up time was 42 months and no patients were lost to follow-up. Results: The average age of the patients was 67 years and 53.8% were female. The pTNM disease stage was IA in 148 patients (30.0%), IB in 125 patients (25.4%), IIA in 96 patients (19.5%), and IIB in 50 patients (10.1%), but 74 (15.0%) were found to be stage IIIA, most often diagnosed perioperatively. The total rate of major complications was 4.7%. Thirty-day mortality was 0.6% (three patients). One- and 5-year overall survival was 85.0% and 49.2%, respectively, with 3-year survival improving from 48.3% to 72.8% between the periods 1991–1994 and 2011–2014 (p = .0004). Advanced TNM stage and age were independent negative prognostic factors for all-cause mortality, and later calendar year and free surgical margins were independent predictors of improved survival. Conclusions: The short-term outcome of lobectomy for NSCLC in this population-based study was excellent, as reflected in the low 30-day mortality and low rate of major complications. The long-term survival was acceptable and the overall 3-year survival had improved significantly during the study period.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
carcinoma, Lobectomy
in
Acta Oncologica
volume
56
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85015904792
  • pmid:28325129
  • wos:000401721200006
ISSN
0284-186X
DOI
10.1080/0284186X.2017.1304652
language
English
LU publication?
yes
id
9df7799b-2d85-4edd-b629-628ef8f1f713
date added to LUP
2017-04-23 13:50:12
date last changed
2017-09-18 13:32:56
@article{9df7799b-2d85-4edd-b629-628ef8f1f713,
  abstract     = {<p>Introduction: Lobectomy is the standard curative treatment for non-small cell carcinoma (NSCLC) of the lung. Most studies on lobectomy have focused on short-term outcome and 30-day mortality. The aim of this study was to determine both short-term and long-term surgical outcome in all patients who underwent lobectomy for NSCLC in Iceland over a 24-year period. Material and methods: The study involved 489 consecutive patients with NSCLC who underwent lobectomy with curative intent in Iceland, 1991–2014. Patient demographics, pTNM stage, rate of perioperative complications, and 30-day mortality were registered. Overall survival was analyzed with the Kaplan?Meier method. The Cox proportional hazards model was used to evaluate factors that were prognostic of overall mortality. To study trends in survival, the study period was divided into six 4-year periods. The median follow-up time was 42 months and no patients were lost to follow-up. Results: The average age of the patients was 67 years and 53.8% were female. The pTNM disease stage was IA in 148 patients (30.0%), IB in 125 patients (25.4%), IIA in 96 patients (19.5%), and IIB in 50 patients (10.1%), but 74 (15.0%) were found to be stage IIIA, most often diagnosed perioperatively. The total rate of major complications was 4.7%. Thirty-day mortality was 0.6% (three patients). One- and 5-year overall survival was 85.0% and 49.2%, respectively, with 3-year survival improving from 48.3% to 72.8% between the periods 1991–1994 and 2011–2014 (p = .0004). Advanced TNM stage and age were independent negative prognostic factors for all-cause mortality, and later calendar year and free surgical margins were independent predictors of improved survival. Conclusions: The short-term outcome of lobectomy for NSCLC in this population-based study was excellent, as reflected in the low 30-day mortality and low rate of major complications. The long-term survival was acceptable and the overall 3-year survival had improved significantly during the study period.</p>},
  author       = {Oskarsdottir, G. N. and Halldorsson, H. and Sigurdsson, M. I. and Fridriksson, B. M. and Baldvinsson, K. and Orrason, A. W. and Jonsson, S. and Planck, M. and Gudbjartsson, T},
  issn         = {0284-186X},
  keyword      = {carcinoma,Lobectomy},
  language     = {eng},
  month        = {03},
  pages        = {936--942},
  publisher    = {Taylor & Francis},
  series       = {Acta Oncologica},
  title        = {Lobectomy for non-small cell lung carcinoma : a nationwide study of short- and long-term survival},
  url          = {http://dx.doi.org/10.1080/0284186X.2017.1304652},
  volume       = {56},
  year         = {2017},
}