# The surgical outcome of standard lobectomy versus sleeve lobectomy in patients with non-small cell lung cancer: propensity score matching

## TL;DR

This study compares standard and sleeve lobectomy outcomes in lung cancer patients and finds both procedures have similar mortality rates.

## Contribution

The study evaluates sleeve lobectomy safety and outcomes using propensity score matching in non-small cell lung cancer patients.

## Key findings

- Sleeve lobectomy had similar mortality and complication rates compared to standard lobectomy.
- Age over 61, low FEV1, and perineural invasion were poor prognostic factors in both groups.
- Propensity matching confirmed no significant difference in 90-day mortality between the two procedures.

## Abstract

The goal of this study was to compare the patients who underwent standard or sleeve lobectomy for non-small cell lung cancer in terms of postoperative outcomes, prognostic factors and overall survival.

Between January 2002 and January 2020, the patients with squamous cell carcinoma or adenocarcinoma who underwent standard lobectomy or sleeve lobectomy by thoracotomy in our clinic were analysed retrospectively. Standard and sleeve groups were compared after propensity score matching in terms of age, comorbidity, T status, N status and pathological stage. Primary outcomes were morbidity and mortality; the secondary outcome was overall survival.

The study included 476 patients, and sleeve lobectomy was performed in 196 (41.1%) patients. Multivariable analysis revealed that age over 61 years (P = 0.003 and P = 0.005, respectively), forced expiratory volume in 1 s (FEV1) below 84% (P = 0.013 and P = 0.205, respectively) and the presence of perineural invasion (P = 0.052 and P = 0.001, respectively) were poor prognostic factors in the standard lobectomy and the sleeve groups. The propensity matching analysis included 276 patients (138 sleeve lobectomy and 138 standard lobectomy). Complications occurred in 96 (69.6%) and 92 (66.7%) patients in the standard and sleeve groups, respectively (P = 0.605). Three (2.2%) patients in the standard group and 5 (3.6%) patients in the sleeve group died within 90 days postoperatively (P = 0.723).

Bronchial sleeve lobectomy is a safe procedure that can be applied in oncologically suitable cases without causing higher mortality than a standard lobectomy.

Lung cancer is one of the most common types of cancers worldwide, and deaths due to lung cancer rank first among all cancer-related deaths.