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Vol. 39. Issue 5.
Pages 217-220 (May 2003)
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Vol. 39. Issue 5.
Pages 217-220 (May 2003)
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Lobectomía frente a resección limitada en el tratamiento del cáncer pulmonar no microcítico en estadio I. Estudio de 78 casos
Lobectomy versus limited resection to treat non-small cell lung cancer in stage I: a study of 78 cases
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J.J. Fibla Alfara
Corresponding author
juanjofibla@hotmail.com

Correspondencia: Servicio de Cirugía Torácica. Hospital de la Santa Creu i Sant Pau. Sant Antoni M. Claret, 167. 08025 Barcelona. España
, G. Gómez Sebastián, C. Farina Ríos, A. Carvajal Carrasco, G. Estrada Saló, C. León González
Servicio de Cirugía Torácica. Hospital de la Santa Creu i Sant Pau. Barcelona. España
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Objetivo

Comparar la tasa de mortalidad y recidiva locorregional de nuestra serie de pacientes intervenidos por un cáncer pulmonar no microcítico en estadio I durante el período 1994–1998, divididos en dos grupos: a) intervenidos de lobectomía, y b) intervenidos de resección pulmonar sublobar (cuña pulmonar)

Pacientes Y Métodos

Se han revisado retrospectivamente 78 casos de resección pulmonar por cáncer pulmonar no microcítico en estadio I realizada entre enero de 1994 y diciembre de 1998: 50 sometidos a lobectomía y 28 a resección sublobar (cuña pulmonar). Se recogieron antecedentes oncológicos, histología de los tumores, recidiva locorregional y mortalidad relacionada con el tumor durante el período de seguimiento

Resultados

El estudio histológico de las lobectomías evidenció 36 carcinomas escamosos (72%), 12 adenocarcinomas (24%) y dos carcinomas de células grandes (4%). En el caso de las cuñas puso de manifiesto 12 carcinomas escamosos (42,8%) y 16 adenocarcinomas (57,2%). En cuanto a los estadios, en las lobectomías, en 15 (30%) era Ia y en 35 (70%) Ib, y en las cuñas, en 16 (57,2%) era Ia y en 12 (42,8%), Ib. Hubo recidiva locorregional en 9 lobectomías (18%) y en 4 cuñas (14,3%), más un caso de metástasis a distancia (3,6%). En cuanto a la mortalidad durante el seguimiento, fallecieron 8 pacientes (16%) sometidos a lobectomías y 4 (14,3%) sometidos a cuñas. La tasa de supervivencia acumulada (en meses) fue de 62,38 y 63,92 en lobectomías y cuñas, respectivamente. Los datos obtenidos no presentaron diferencias estadísticamente significativas en lo que se refiere a recidiva locorregional y supervivencia acumulada entre ambos grupos

Conclusiones

En este trabajo las tasas de recidiva locorregional y supervivencia acumulada son concordantes con las de otros estudios retrospectivos. En nuestra serie no hallamos diferencias estadísticamente significativas entre los pacientes sometidos a lobectomía y los sometidos a resección sublobar. La resección en cuña resulta una técnica adecuada para aquellos pacientes con un carcinoma pulmonar no microcítico en estadio I que no pueden tolerar una lobectomía

Palabras clave:
Resección sublobar
Resección en cuña
Segmentectomía
Objective

To compare mortality and loco-regional recurrence rates in patients treated surgically for stage I non-small cell lung cancer by either lobectomy or sublobar lung resection (pulmonary wedge) from 1994 to 1998

Patients And Methods

Seventy-eight patients who underwent lung resection for stage I non-small cell lung cancer from January 1994 to December 1998 were reviewed retrospectively. Fifty patients underwent lobectomy and 28 limited resection (pulmonary wedge). We reviewed oncologic history, tumor histology, loco-regional recurrence and tumor-related mortality during the follow-up period

Results

Histology, lobectomies: 36 (72%) squamous cell carcinomas, 12 (24%) adenocarcinomas and 2 (4%) large cell carcinomas. Histology, wedge resection: 12 (42.8%) squamous cell carcinomas and 16 (57.2%) adenocarcinomas. Staging, lobectomies: 15 Ia (30%) and 35 Ib (70%). Staging, wedge resections: 16 Ia (57.2%) and 12 Ib (42.8%). Loco-regional recurrence: lobectomies 9 (18%) and wedge resections 4 (14.3%) plus 1 remote metastasis (3.6%). Mortality during follow-up: lobectomies 8 (16%) and wedge resections 4 (14.3%). Accumulated survival rate (in months): lobectomies 62.38 and wedge resections 63.92. The rates of loco-regional recurrence and accumulated survival in the two groups were not significantly different

Conclusions

The rates of loco-regional recurrence and accumulated survival in this study agree with those from other retrospective studies. We found no statistically significant differences between patients undergoing lobectomy and those undergoing sublobar resection. Wedge resection is an appropriate technique for patients with stage I non-small cell lung cancer who can not tolerate lobectomy

Keywords:
Sublobar resection
Wedge resection
Segmentectomy
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