To compare the oncological outcomes of segmentectomy for non-peripheral versus peripheral small-sized non-small cell lung cancer (NSCLC). This retrospective observational study included patients with clinical stage IA1-A2 NSCLC who underwent segmentectomy. Patients were separated based on tumour distance index (DI, which was calculated as the ratio of the distance from the entrance of the segmental bronchus to the proximal tumour margin to the distance to the lobar pleura along the same line): non-peripheral group (DI ≤ 2/3) and peripheral group (DI > 2/3). Disease-free survival (DFS) and Overall survival (OS) were compared with log-rank tests. 850 patients were included, comprising 274 in the non-peripheral group and 576 in the peripheral group. Recurrence occurred in 68 patients (24 in the peripheral group and 44 in the non-peripheral group), and 56 patients died (22 in the peripheral group and 34 in the non-peripheral group). Log-rank tests showed no statistical differences in 5-year DFS (92.2% vs 91.2%) and 5-year OS (96.3% vs 93.6%) between two groups, but higher margin recurrence occurred in the non-peripheral group. Multivariable analysis revealed that age, tumour diameter, consolidation-to-tumour ratios (CTR), pathological subtype, and pathologic stage were independent risk factors for DFS. Subgroup analysis indicated that patients with a non-peripheral solid NSCLC had a worse 5-year DFS (62.1% vs 76.3%) and a higher margin recurrence rate (13.2% vs 2.0%). Segmentectomy for small-sized non-peripheral NSCLC could gain a comparable outcome to the peripheral, but worse DFS and higher margin recurrence occurred in the non-peripheral solid NSCLC.
Background: Data regarding the safety and efficacy of delayed completion lobectomy (CL) following sublobar resections remain scant. We evaluated the technical difficulty and short-term outcomes of CL occurring at least 3 months following the anatomical segmentectomy or wedge resection. Methods: Consecutive non-small cell lung cancer (NSCLC) patients who underwent a second resection within the same lobe at least 3 months after their initial resection from January 2013 to December 2019 at the Shanghai Pulmonary Hospital were retrospectively included. The patients were divided into a segmentectomy group (SG group) and a wedge resection group (WR group) based on their initial resection strategy. Baseline characteristics and short-term outcomes after CL between the two groups were compared. Results: Twenty-five patients undergoing CL were included, nine in the SG group and 16 in the WR group. No deaths occurred within 30 days postoperatively, and the rate of overall postoperative complications was 28.0% (7/25). Statistically significant differences were found in rates of postoperative complications between the two groups (SG: 55.6% vs. WR: 12.5%, P=0.03) and in the use of bronchoplasty or angioplasty during the CL (SG: 33.3% vs. WR: 0.0%, P=0.04). After CL, no significant differences were found in 5-year recurrence-free survival (RFS) (WR: 66.7% vs. SG: 61.0%, P=0.31) or overall survival (OS) (WR: 93.8% vs. SG: 66.7%, P=0.06) between two groups. Conclusions: Delayed CL occurring over 3 months after sublobar resection is a safe and effective procedure, with no deaths occurring within 30 days postoperatively. As compared to a segmentectomy at the time of the index operation, a wedge resection may portend less morbidity, with a decreased risk of needing adjunctive bronchoplasty or angioplasty procedures during CL. After CL, 5-year RFS and OS were comparable between WR and SG groups.
The therapeutic efficacy of nanozymes, which have wide applications in cancer treatment, can be enhanced by various biomimetic design strategies, from structural and process mimicry to advanced functional biomimicry.
Abstract This research focuses on smoking as a key factor in lung squamous cell carcinoma, aiming to understand its precise mechanisms. Emphasizing blood metabolites as intermediary variables, the study employs a two-step Mendelian randomization analysis, including univariable and multivariable approaches, to uncover pathways connecting smoking to lung cancer. The significance of this investigation lies in addressing the prevalence of smoking-related cancers, contributing to preventive strategies. Identified blood metabolites may serve as biomarkers or therapeutic targets. Tasks include using MR methods like inverse variance weighting, MR-Egger regression, and weighted median, considering potential confounding factors. Prerequisite knowledge encompasses the understanding of genetic variants associated with smoking, blood metabolites, and lung squamous cell carcinoma for a nuanced analysis.
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