Risk Factors for Locoregional Relapse After Segmentectomy: Supplementary Analysis of the JCOG0802/WJOG4607L Trial.

Nevertheless, locoregional relapse (LR) is a major issue for segmentectomy.

然而，局部区域复发（LR）是段切除术面临的一个主要问题。

An ad hoc supplementary analysis aimed to determine the risk factors for LR and the degree of advantages of segmentectomy on the basis of primary tumor sites.

一项特别的补充分析旨在确定局部复发（LR）的风险因素以及基于原发肿瘤部位的肺段切除术的优势程度。

Methods

Participants in multi-institutional and intergroup, open-label, phase 3 randomized controlled trialin Japan were enrolled from August 10, 2009, to October 21, 2014.

参与者在日本的一个多机构、跨组别、开放标签、第3阶段随机对照试验中，从2009年8月10日至2014年10月21日被纳入。

Risk factors for LR after segmentectomy and clinical features following the primary tumor site were investigated.

研究了段切除术后局部复发的风险因素以及原发肿瘤部位的临床特征。

Results

Of 1105 patients, 576 and 529 underwent lobectomy and segmentectomy, respectively.

在1105名患者中，有576名接受了肺叶切除术，529名接受了段切除术。

The primary tumor site for segmentectomy was the left upper division, left lingular segment, left S6, left basal segment, right upper lobe, right S6, or right basal segment.

段切术的主要肿瘤部位包括左上叶段、左舌段、左S6段、左基底段、右上叶、右S6段或右基底段。

Multivariable analysis in the segmentectomy group revealed that pure-solid appearance on thin-section computed tomography (OR = 3.230; 95% confidence interval[CI]: 1.559-6.690; p = 0.0016), margin distance less than the tumor size (OR = 2.682; 95% CI: 1.350-5.331; p = 0.0049), and male sex (OR = 2.089; 95% CI: 1.047-4.169; p = 0.0366) were significantly associated with LR.

段切术组的多变量分析显示，薄层计算机断层扫描上的纯实性表现（OR = 3.230; 95%置信区间[CI]: 1.559-6.690; p = 0.0016）、切缘距离小于肿瘤大小（OR = 2.682; 95% CI: 1.350-5.331; p = 0.0049）以及男性性别（OR = 2.089; 95% CI: 1.047-4.169; p = 0.0366）与局部复发显著相关。

Patients with left lingular segment tumors (OR = 4.815; 95% CI: 1.580-14.672) tended to experience LR more frequently than those with left upper division tumors, although primary tumor sites were not statistically significant.

左肺舌段肿瘤患者（比值比=4.815；95%置信区间：1.580-14.672）相较于左上叶肿瘤患者更容易出现局部复发（LR），尽管原发肿瘤部位在统计学上并不显著。

Conclusions

Thin-section computed tomography findings and margin distance are important factors to avoid LR in segmentectomy.

薄层计算机断层扫描结果和切缘距离是避免段切除术后局部复发（LR）的重要因素。