title: Sublobectomy versus lobectomy for stage I non-small cell lung cancer in the elderly.
abstract: OBJECTIVE
  The aim of our study was to compare the operative characteristics and long term survival for elderly patients with stage I non-small cell lung cancer (NSCLC) who underwent sublobectomy versus lobectomy.
  
  
  METHODS
  We identified 245 consecutive elderly patients (≥65y) with pathologic stage I NSCLC who underwent lobectomy or sublobectomy at our institution between 2006 and 2012, and assessed the operative characteristics, recurrence, and survival differences between these approaches.
  
  
  RESULTS
  A total of 39 patients underwent sublobectomy and 206 patients had lobectomy. There were significantly more COPD (p = 0.046) and low percent of predicted FEV1 (p = 0.034) in sublobectomy patients compared to the lobectomy group. Sublobectomy patients had significantly shorter operating time (p = 0.001), less blood loss (p = 0.000), and trended toward fewer chest tube days (p = 0.001) and shorter hospital length of stay (p = 0.030). The 1-, 3-, and 5-year survival rates in patients with lobectomy were 91.3, 77.7, and 64.1%, respectively, and has no significantly difference with those underwent sublobectomy (87.2, 74.4, and 61.5%, respectively, p = 0.623). Subgroups survival analysis showed no significant difference in the OS and DFS for patients with T < 2 cm or %FEV1<80%, but survival after sublobectomy was worse if performed on patients with larger tumours (T ≥ 2 cm) or relatively strong lung function (%FEV1≥80%).
  
  
  CONCLUSIONS
  We concluded that sublobectomy might achieve similar survival rates when compared with lobectomy in elderly stage I NSCLC patients, especially for patients with low %FEV1 and stage IA tumours less than 2 cm in diameter.
authors.affiliation: Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China; Department of Oncology, Shandong University Qilu Hospital, Shandong University, #107 West Wenhua Road, Jinan 250010, PR China.
authors.forename: Chen
authors.initials: C
authors.lastname: Qiu
authors.affiliation: Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China.
authors.forename: Guanghui
authors.initials: G
authors.lastname: Wang
authors.affiliation: Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China; Department of Thoracic Surgery, Jining First People's Hospital of Shandong Province, #6 Health Road, Jining 272111, PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.affiliation: Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China.
authors.forename: Lixuan
authors.initials: L
authors.lastname: Cui
authors.affiliation: Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
authors.affiliation: Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Ni
authors.affiliation: Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Qu
authors.affiliation: Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China; Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China. Electronic address: dujiajun568@163.com.
authors.forename: Jiajun
authors.initials: J
authors.lastname: Du
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D061646:Operative Time; D011013:Pneumonectomy / Q000379:methods*; D012189:Retrospective Studies
keywords: Elderly; Lobectomy; NSCLC; Segmentectomy; Wedge resection