具有足够边缘的亚叶切除可与局部区域复发的叶片切除相比较
Megumi Nishikubo1, Tappei Shomoto1, Sanae Kuroda1
1Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan.
Interdisciplinary cardiovascular and thoracic surgery
|February 11, 2026
概括
对于非小细胞肺癌 (NSCLC),在亚叶切除时有足够的边缘可以提供与分叶切除相似的局部控制. 然而,纯固体结节可能需要比传统使用的更宽的边缘.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 肺部医学 肺部医学
背景情况:
- 亚叶切除是小型外围非小细胞肺癌 (NSCLC) 的标准.
- 在NSCLC中进行亚叶膜切除的最佳边缘距离尚未确立.
- 在分叶切除和分叶切除之间比较局部区域复发 (LRR) 率至关重要.
研究的目的:
- 评估NSCLC的亚叶膜切除中边缘距离的充分性.
- 为了比较足够/不足边缘的亚叶切除和叶片切除术之间的局部区域复发率 (LRR).
- 根据边缘状态确定小外围NSCLC的最佳外科手术方法.
主要方法:
- 在2018年4月至2024年3月期间,对505名完全切除 (≤3厘米) NSCLC (腺癌,状细胞癌,腺状细胞癌) 的患者进行了回顾性评估.
- 在分叶切除 (足够/不足的边缘) 和分叶切除组之间,免于局部区域复发 (FLRR) 率和累积LRR风险的比较.
- 对纯固体结节与其他亚型进行分层分析.
主要成果:
- 在整体队列中,不足的边缘分叶切除比足够的边缘分叶切除和分叶切除 (5年FLRR:75.1%对95.9%对95.8%).
- 足够的边缘亚叶切除显示,在整体队列中,LRR风险与叶切除术相比较.
- 在纯固体结节子组中,不够和足够的边缘亚叶切除术与叶切除术相比,具有更高的LRR风险.
结论:
- 带有足够边缘的亚叶切除可以提供与NSCLC的分叶切除相似的局部控制.
- 在下叶叶切除中缺少足够的边缘会增加局部区域性复发风险.
- 对于纯固体NSCLC结节来说,传统的边缘距离可能不够,这表明需要进行分叶切除术或更宽的边缘.
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