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2026年8月13日星期四
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中央型小尺寸非小细胞肺癌肺段切除术的肿瘤学结局：多中心研究（CReGYT-02研究）

Oncological Outcomes of Segmentectomy for Centrally Located Small-Sized Non-small-cell Lung Cancer: A Multicenter Study (CReGYT-02 Study).

期刊
Annals of Surgical Oncology
PMID
42576113
原文
PubMed ↗
发布日期

作者

  • Kazuki Takada — Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan. takadakazuki1077@gmail.com.
  • Takamasa Koga — Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
  • Kotaro Nomura — Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
  • Taichi Matsubara — Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Takamitsu Hayakawa — First Department of Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan.
  • Ryo Fujikawa — Department of Thoracic Surgery, Shimada General Medical Center, Shizuoka, Japan.
  • Akira Hamada — Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
  • Kosuke Fujino — Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
  • Shinya Katsumata — Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
  • Hikaru Watanabe — Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Japan.
  • Jun Suzuki — Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Japan.
  • Fumihiko Kinoshita — Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Naoki Haratake — Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan.
  • Miyuki Abe — Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan.
  • Shinkichi Takamori — Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan.
  • Shinya Tane — Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Hironobu Hoshino — Department of Surgery, NHO Okinawa Hospital, Okinawa, Japan.
  • Hiroyuki Tsuchida — Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
  • Satoshi Muto — Department of Chest Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.
  • Makoto Endo — Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
  • Tomoyoshi Takenaka — Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Tomoharu Yoshizumi — Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Mototsugu Shimokawa — Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
  • Junichi Soh — Department of Thoracic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Yasuhisa Ohde — Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.

作者单位

  • Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan. takadakazuki1077@gmail.com.
  • Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
  • Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
  • Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • First Department of Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan.
  • Department of Thoracic Surgery, Shimada General Medical Center, Shizuoka, Japan.
  • Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
  • Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
  • Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Japan.
  • Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan.
  • Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Department of Surgery, NHO Okinawa Hospital, Okinawa, Japan.
  • Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
  • Department of Chest Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.
  • Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
  • Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
  • Department of Thoracic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.

摘要

中文

中央型小尺寸非小细胞肺癌（NSCLC）行肺段切除术的肿瘤学适宜性仍不清楚。本研究比较了中央型临床IA期NSCLC行肺段切除术与肺叶切除术的结局。这项回顾性多中心队列研究使用了来自日本17家机构的CReGYT-02数据库。纳入2012年至2016年间接受肺段切除术或肺叶切除术的临床IA期NSCLC（第8版）、肿瘤≤3cm且实性成分占比>0.5的患者。排除位于肺实质外三分之一处的肿瘤。结局包括无复发生存期、总生存期、复发模式以及复发或其他癌症诊断时的体能状态和治疗。进行Kaplan-Meier分析和Cox比例风险模型，并在逆概率治疗加权前后进行分析。在479名符合条件的患者中，26名接受了肺段切除术，453名接受了肺叶切除术。逆概率治疗加权后，肺段切除术与较差的无复发生存期（风险比0.71；95%置信区间0.31-1.67）或总生存期（风险比1.12；95%置信区间0.46-2.70）无关。肺段切除术后复发率为7.7%，肺叶切除术后为21.0%；肺段切除术后无局部区域复发。肺段切除术组所有患者在复发或其他癌症诊断时均保持体能状态0-1并接受治疗。在高度选择的中央型小尺寸NSCLC患者中，与肺叶切除术相比，肺段切除术与较差的肿瘤学结局或较高的局部区域失败无关。然而，由于肺段切除术队列非常小，这些发现应谨慎解读，并需要在更大规模的前瞻性研究中验证。

English

The oncologic appropriateness of segmentectomy for centrally located small-sized non-small-cell lung cancer (NSCLC) remains unclear. This study evaluated the outcomes of segmentectomy compared with lobectomy for centrally located clinical stage IA NSCLC. This retrospective multicenter cohort study used the CReGYT-02 database from 17 Japanese institutions. Patients with clinical stage IA NSCLC (8th edition), tumor ≤3 cm, and consolidation-to-tumor ratio > 0.5 who underwent segmentectomy or lobectomy between 2012 and 2016 were included. Tumors located in the outer one-third of the lung parenchyma were excluded. Outcomes included recurrence-free survival, overall survival, recurrence patterns, and performance status and treatment at recurrence or diagnosis of other cancers. Kaplan-Meier analysis and Cox proportional hazards models were performed before and after inverse probability of treatment weighting. Among 479 eligible patients, 26 underwent segmentectomy and 453 lobectomy. After inverse probability of treatment weighting, segmentectomy was not associated with inferior recurrence-free survival (hazard ratio 0.71; 95% confidence interval 0.31-1.67) or overall survival (hazard ratio 1.12; 95% confidence interval 0.46-2.70). Recurrence occurred in 7.7% after segmentectomy and 21.0% after lobectomy; no locoregional recurrences occurred after segmentectomy. All patients in the segmentectomy group maintained performance status 0-1 and received treatment at recurrence or diagnosis of other cancers. Segmentectomy was not associated with worse oncologic outcomes or increased locoregional failure compared with lobectomy among highly selected patients with centrally located small-sized NSCLC. However, because the segmentectomy cohort was very small, these findings should be interpreted cautiously and require validation in larger prospective studies.

分类与指标

研究类型
临床研究
病种
肺癌
JCR 分区
Q1
影响因子
3.8
新锐分区
2区