title: Clinical outcomes and changes in lung function after segmentectomy versus lobectomy for lung cancer cases.
abstract: OBJECTIVE
  We compared the clinical outcomes and changes in pulmonary function test (PFT) results after segmentectomy or lobectomy for non-small cell lung cancer.
  
  
  METHODS
  The retrospective study included 212 patients who had undergone segmentectomy (group S) and 2336 patients who had undergone lobectomy (group L) from 1997 to 2012. The follow-up and medical record data were collected. We used all the longitudinal PFT data within 24 months postoperatively and performed linear mixed modeling. We analyzed the 5-year overall and disease-free survival in stage IA patients. We used propensity score case matching to minimize the bias due to imbalanced group comparisons.
  
  
  RESULTS
  During the perioperative period, 1 death (0.4%) in group S and 7 (0.3%) in group L occurred. The hospital stay for the 2 groups was similar (median, 5.0 vs 5.0 days; range, 2-99 vs 2-58). The mean overall and disease-free survival period of those with T1a after segmentectomy or lobectomy seemed to be similar (4.2 vs 4.5 years, P=.06; and 4.1 vs 4.4 years, P=.07, respectively). Compared with segmentectomy, lobectomy yielded marginally significantly better overall (4.4 vs 3.9 years, P=.05) and disease-free (4.1 vs 3.6 years; P=.05) survival in those with T1b. We did not find a significantly different effect on the PFTs after segmentectomy or lobectomy.
  
  
  CONCLUSIONS
  Both surgical types were safe. We would advocate lobectomy for patients with stage IA disease, especially those with T1b. A retrospective study with a large sample size and more detailed information should be conducted for PFT evaluation, with additional stratification by lobe and laterality.
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn; Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Deng
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Cassivi
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn.
authors.forename: Mariza
authors.initials: M
authors.lastname: de Andrade
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn.
authors.forename: Francis C
authors.initials: FC
authors.lastname: Nichols
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn.
authors.forename: Victor F
authors.initials: VF
authors.lastname: Trastek
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn; School of Environmental Science and Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Wampfler
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn.
authors.forename: Shawn M
authors.initials: SM
authors.lastname: Stoddard
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn.
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Wigle
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Shen
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Allen
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn.
authors.forename: Claude
authors.initials: C
authors.lastname: Deschamps
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn. Electronic address: yang.ping@mayo.edu.
authors.forename: Ping
authors.initials: P
authors.lastname: Yang
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome
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