• Chen Qiu, Guanghui Wang, Jun Xu, Lixuan Cui, Wei Dong, Yang Ni, Xiao Qu, and Jiajun Du.
• Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China; Department of Oncology, Shandong University Qilu Hospital, Shandong University, #107 West Wenhua Road, Jinan 250010, PR China.
• Int J Surg. 2017 Jan 1; 37: 1-7.

ObjectiveThe aim of our study was to compare the operative characteristics and long term survival for elderly patients with stage I non-small cell lung cancer (NSCLC) who underwent sublobectomy versus lobectomy.MethodsWe identified 245 consecutive elderly patients (≥65y) with pathologic stage I NSCLC who underwent lobectomy or sublobectomy at our institution between 2006 and 2012, and assessed the operative characteristics, recurrence, and survival differences between these approaches.ResultsA total of 39 patients underwent sublobectomy and 206 patients had lobectomy. There were significantly more COPD (p = 0.046) and low percent of predicted FEV1 (p = 0.034) in sublobectomy patients compared to the lobectomy group. Sublobectomy patients had significantly shorter operating time (p = 0.001), less blood loss (p = 0.000), and trended toward fewer chest tube days (p = 0.001) and shorter hospital length of stay (p = 0.030). The 1-, 3-, and 5-year survival rates in patients with lobectomy were 91.3, 77.7, and 64.1%, respectively, and has no significantly difference with those underwent sublobectomy (87.2, 74.4, and 61.5%, respectively, p = 0.623). Subgroups survival analysis showed no significant difference in the OS and DFS for patients with T < 2 cm or %FEV1<80%, but survival after sublobectomy was worse if performed on patients with larger tumours (T ≥ 2 cm) or relatively strong lung function (%FEV1≥80%).ConclusionWe concluded that sublobectomy might achieve similar survival rates when compared with lobectomy in elderly stage I NSCLC patients, especially for patients with low %FEV1 and stage IA tumours less than 2 cm in diameter.Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

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