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Abstract: Objectives To assess the impact of lung resection extent on early-stage non-small cell lung cancer with a history of any cancer. Methods Retrospective multicentric cohort study including patients with ≤2 cm pathologic size lung cancer with a history of any cancer, operated on from 2015 to 2021 across nine European centers (one per country). Overall survival (OS), disease-free survival (DFS) and lung cancer specific death (LCSD) between both groups were assessed before and after propensity score (PS) −matching. Risk factors for oncologic outcomes were analyzed using parsimonious model cox proportional hazard regression. Kaplan Meier and cumulative incidence function assessed the outcomes. Log-rank test and Gray’ test compared the groups. Linearized risk was used to assess recurrences. Results Of the 1910 patients with early-stage lung cancer patients, 540 (28.2%) had a prior cancer. Lobectomy and segmentectomy were performed in 409 (75.7%) and 131 (24.3%) patients respectively. 5-year OS rates: lobectomy 81.5%, segmentectomy 80.8%, p = 0.8; DFS: lobectomy 76.9%, segmentectomy 74.4%, p = 0.6 and LCSD: lobectomy 8.0%, segmentectomy 4.9%, p = 0.2. These finding were similar in the matched cohort. Locoregional recurrence (linearized risk: lobectomy 0.111, segmentectomy 0.066) and distant recurrence (linearized risk: lobectomy 0.093, segmentectomy 0.055) were not worse in the segmentectomy group. In multivariable analysis, prior cancer negatively impacted only lung cancer specific death HR:1.27 (95%CI:1.00–1.60). Conclusion Compared to lobectomy, segmentectomy has not shown a worse oncologic outcome in patients with history of any prior cancer.
Keywords: segmentectomy, cancer, early-stage, non-small lung, canceroutcome
Published in DiRROS: 27.07.2026; Views: 233; Downloads: 114
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Abstract: Objectives: To investigate the prognosis of peripheral early-stage lung adenocarcinoma patterns treated by lobectomy or segmentectomy. Methods: Retrospective multicentric cohort of patients with cT1a-bN0M0 lung adenocarcinoma who underwent lobectomy or segmentectomy with systematic lymph node dissection in 10 European centers (one per country) from 2015 to 2021. Overall survival (OS), disease-free survival (DFS), and lung cancer–specific death (LCSD) between both groups were assessed in entire dataset and in dataset of histologic aggressive patterns, before and after propensity score-matching (PSM). Prognostic risk factors were analyzed using parsimonious model Cox regression. Recurrences were assessed by linearized risks. Results: Lobectomy and segmentectomy were performed in 1029 (73.1%) and 377 (26.8%) patients, respectively. In total, 427 (30.3%) patients had at least 1 histologic aggressive (micropapillary or solid) pattern, and 88 patients (20.7%) underwent segmentectomy. OS, DFS, and LCSD rates were similar between patients who underwent lobectomy or segmentectomy, in both datasets, before and after PSM. In aggressive dataset, PSM, 5-year OS rates were lobectomy 88.0% (95% CI, 80.9-95.7%), segmentectomy 89.1% (95% CI, 82.2-96.6%), P = .8; 5-year DFS rates were lobectomy 79.8% (95% CI, 70.8-89.8%), segmentectomy 80.6% (95% CI, 71.6-90.6%), P = .6; and 5-year LCSD rates were lobectomy 6.0%, segmentectomy 7.8%, P = .8. Locoregional recurrence was not superior in patients who underwent segmentectomy in entire dataset (linearized risks: lobectomy 0.078, segmentectomy 0.073) and in aggressive dataset (linearized risks: lobectomy 0.036, segmentectomy 0.011) only in the unmatched cohorts. Aggressive histologic patterns impacted on only LCSD, and only when they were dominant. Conclusions: Segmentectomy seems comparable to lobectomy for patients with peripheral cT1a-bN0M0 lung adenocarcinoma even in case of histologic aggressive patterns.
Keywords: lobectomy, lung adenocarcinoma, segmentectomy, patterns, prognosis
Published in DiRROS: 24.04.2026; Views: 324; Downloads: 150
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Abstract: Background: Chest drains are routinely used after video-assisted thoracoscopic surgery (VATS) lung resections to evacuate fluid and air from the pleural space. We compared the impact of coaxial silicone (SIL) drains vs. standard polyvinyl chloride (PVC) drains on postoperative pain, drainage efficacy, and short-term treatment outcome following VATS lobectomy. Methods: The prospective randomized study included 80 patients who underwent VATS lobectomy for lung cancer between September 2020 and June 2023. Patients were randomized into two groups based on the type of chest drain used postoperatively: 40 in the experimental group (coaxial SIL drain Fr 24) and 40 in the control group (standard PVC drain Fr 24). The researchers collecting the data and the caregivers were not blinded to the group allocation. The primary objective was to evaluate pain over the initial 2 postoperative days by assessing analgesic consumption, respiratory muscle strength [measured as maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)], and pain intensity using the visual analog scale (VAS). MIP, MEP, and VAS were measured both at rest and during physical activity. Results: Sixty-nine patients were included in the final analysis: 35 in the experimental group and 34 in the control group. The groups were comparable in terms of drainage efficacy and short-term treatment outcome, but pain was significantly lower in the experimental group (coaxial SIL drain). Diclofenac consumption was significantly lower in the experimental group (P=0.004), with a trend toward lower consumption of other analgesics. All respiratory muscle strength measurements were higher in the experimental group, with significant differences in static MIP on the second postoperative day (P=0.046), both static (P=0.02) and dynamic (P=0.050) MEP on the first postoperative day, and static MEP on the second postoperative day (P=0.02). Static VAS (S-VAS) on the first postoperative day was statistically significantly lower in the experimental group (P=0.003). Dynamic VAS (D-VAS) was comparable between the groups. Conclusions: This study confirmed the hypothesis that coaxial SIL drains, owing to their softer material, cause less pain while maintaining efficacy comparable to standard PVC drains.
Keywords: video-assisted thoracoscopic surgery, VATS, lobectomy, postoperative pain, chest tube, analgesia
Published in DiRROS: 12.12.2025; Views: 613; Downloads: 337
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Keywords: elektronske knjige
Published in DiRROS: 24.11.2022; Views: 2635; Downloads: 1193
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Abstract: Ureditev prehranskega statusa je eden glavnih ciljev pri bolnikih z rakom požiralnika, saj ima pomemben vpliv na potek in uspeh zdravljenja. Zaradi pogostega pojava disfagije in oteženega uživanja hrane skozi usta je pogosto treba že pred začetkom zdravljenja vzpostaviti prehransko pot. Izkazalo se je, da sta pri bolnikih na radikalnem zdravljenju, to je z namenom ozdravitve, NGS in perkutana hranilna stoma superiorni samorazteznim kovinskim opornicam. Čeprav samoraztezne kovinske opornice omogočajo hitro izboljšanje disfagije, so zaradi pogostih zapletov, tudi življenje ogrožajočih, primerne predvsem v sklopu paliativnega zdravljenja. V prispevku je opisan primer bolnika z rakom požiralnika na predoperativnem zdravljenju s predhodno vstavljeno samoraztezno kovinsko opornico.
Keywords: rak požiralnika, disfagija, samoraztezna kovinska opornica
Published in DiRROS: 10.06.2021; Views: 3561; Downloads: 857
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