Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung Adenocarcinoma

Abstract

Background

To investigate postoperative temporary consequences of the enrolled patients with lung adenocarcinoma.

Patients and Methods

We analyzed the clinical data of patients with lung adenocarcinoma admitted by the same surgical team of Peking Union Medical College Hospital (PUMCH) from July 2019 to December 2019. Statistical methods including propensity score matching (PSM) analysis was used to analyze the differences among them.

Results

A total of 108 patients were enrolled, including 50 patients with sublobar resection and 58 patients with lobectomy. Before PSM, there were statistically significant differences in age ( p=0.015), hospitalization costs ( p=0.042), lymphadenectomy ( p=0.000), pathological staging ( p=0.000), number of lymph nodes removed ( p=0.000), number of positive lymph nodes ( p=0.034), chest drainage duration ( p=0.000), total chest drainage ( p=0.000), length of postoperative hospital stays ( p=0.000), postoperative D-dimer level ( p=0.030) and perioperative lymphocyte margin (LM) ( p=0.003) between sublobar resection and lobectomy. After PSM, there were statistical differences in number of lymph nodes removed ( p=0.000), chest drainage duration ( p=0.031) and total chest drainage ( p=0.002) between sublobar resection and lobectomy. Whether with PSM analysis or not, there were no significant differences in other blood test results, such as inflammation indicators, postoperative neutrophil-lymphocyte ratio (NLR), albumin level, perioperative activity of daily living (ADL) scale scoring margin, complications, postoperative admission to intensive care unit (ICU) and readmission within 30 days. NLR was associated with total chest drainage ( p=0.000), length of postoperative hospital stays ( p=0.000), postoperative D-dimer level ( p=0.050) and ADL scale scoring margin ( p=0.003) between sublobar resection and lobectomy.

Conclusion

Sublobar resection, including wedge resection and segmentectomy, was as safe and feasible as lobectomy in our study, and they shared similar short-term outcomes. Postoperative NLR could be used to detect the clinical outcomes of patients. Secondary resectability of pulmonary function (SRPF) should be the main purpose of sublobar resection.