Thesis etd-10192021-214043 |
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Thesis type
Tesi di specializzazione (5 anni)
Author
VOKRRI, EDUART
URN
etd-10192021-214043
Thesis title
Segmentectomia semplice e complessa VATS come procedura indicata in casi selezionati di pazienti con NSCLC stadio clinico IA
Department
PATOLOGIA CHIRURGICA, MEDICA, MOLECOLARE E DELL'AREA CRITICA
Course of study
CHIRURGIA TORACICA
Supervisors
relatore Prof. Voltolini, Luca
correlatore Dott. Bongiolatti, Stefano
correlatore Dott. Bongiolatti, Stefano
Keywords
- pulmonary complex segmentectomy
- pulmonary simple segmentectomy
- segmentectomia polmonare complessa
- segmentectomia polmonare semplice
- Segmentectomia VATS
- VATS segmentectomy
Graduation session start date
05/11/2021
Availability
None
Summary
In questo studio retrospettivo abbiamo valutato i risultati immediati postoperatori e i risultati oncologici a lungo termine delle segmentectomie VATS (VATS-S) per NSCLC di stadio clinico IA. Abbiamo analizzato i dati di circa 120 pazienti sottoposti a VATS-S per tumore polmonare dal 2015 al 2020 dividendo due gruppi di VATS-S secondo la classifica di Handa: segmentectomie semplici e complesse. Abbiamo riportato l'appropriatezza della VATS-S con risultati sovrapponibili tra quelli semplici e complessi sia riguardo l'outcome dell'immediato postoperatorio che dei risultati oncologici a lungo termine. Abbiamo riscontrato che la sopravvivenza libera da malattia fosse peggiore per i pazienti con upstage patologico, forme di adenocarcinoma più aggressive e rapporto alto di consolidazione/dimensioni totali del tumore, dove l'upstage patologico risulta statisticamente significativo sia all'analisi univariata che multivariata. Nonostante la natura retrospettiva dello studio questi risultati ci confermano che la VATS-S sia una procedura appropriata e adeguata nel NSCLC di stadio clinico IA
In this retrospective study we evaluate the post-operative outcomes and oncological long-term results of VATS segmentectomy (VATS- S) for clinical stage IA NSCLC.
We analyzed the clinical data of about 120 patients undergoing VATS-S for lung cancer from 2015 to 2020 and we created two groups based on the subtype of VATS-S according to to Handa classification: simple segmentectomy and complex segmentectomy. We demonstrated the safety VATS-S, reporting similar results between complex and simple segmentectomy relatively to post-operative outcomes and oncological long-term results. We found that DFS was worse for patients with pathological upstaging, aggressive subtype of adenocarcinoma and high consolidation- to-tumor ratio, with pathological upstaging as a significant risk factor for worse DFS in both univariate and multivariable analyses. Although the retrospective nature of this study, these results confirmed that VATS-S is a feasible and effective approach for clinical stage IA NSCLC.
In this retrospective study we evaluate the post-operative outcomes and oncological long-term results of VATS segmentectomy (VATS- S) for clinical stage IA NSCLC.
We analyzed the clinical data of about 120 patients undergoing VATS-S for lung cancer from 2015 to 2020 and we created two groups based on the subtype of VATS-S according to to Handa classification: simple segmentectomy and complex segmentectomy. We demonstrated the safety VATS-S, reporting similar results between complex and simple segmentectomy relatively to post-operative outcomes and oncological long-term results. We found that DFS was worse for patients with pathological upstaging, aggressive subtype of adenocarcinoma and high consolidation- to-tumor ratio, with pathological upstaging as a significant risk factor for worse DFS in both univariate and multivariable analyses. Although the retrospective nature of this study, these results confirmed that VATS-S is a feasible and effective approach for clinical stage IA NSCLC.
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