Ann Thorac Surg 2005;79:1467
© 2005 The Society of Thoracic Surgeons
Correspondence
Pneumonectomy Versus Sleeve Lobectomy for Lung Cancer
Thomas J. Birdas, MD
Department of Cardiothoracic Surgery, Allegheny General Hospital, 320 E North Ave, South Tower, 14th Floor, Pittsburgh, PA 15212
(E-mail: tbirdas1{at}aol.com).
To the Editor:
In a very important paper, Deslauriers and colleagues [1] compare the outcomes after sleeve lobectomy and pneumonectomy in a series of 1,230 consecutive patients with nonsmall cell lung cancer. They conclude that sleeve lobectomy is the preferred approach, when feasible, as both the overall survival and the freedom from locoregional recurrences were significantly higher in the sleeve lobectomy group. The authors correctly identify that there are some subtle differences between the two groups that may not easily allow for a direct comparison, an unavoidable bias of a retrospective study. They also point out that survival remained significantly better even when patients with stage I or stage II disease were compared separately.
While this is certainly true in the univariate analysis presented, it is not clear in the manuscript whether a multivariate (proportional hazards) analysis was also performed. Similarly, although the overall rate of locoregional recurrences is higher in the pneumonectomy group, the same confounding variables may play a role, and further statistical analysis could help make the authors' point clearer. This is, without doubt, a very significant contribution in the field of lung cancer surgery, and these observations on the statistical methodology applied may further strengthen the important message conveyed by the paper.
 |
References
|
|---|
- Deslauriers J, Gregoire J, Jaques LF, Piraux M, Guojin L, Lacasse Y. Sleeve lobectomy versus pneumonectomy for lung cancer: a comparative analysis of survival and sites or recurrences Ann Thorac Surg 2004;77:1152-1156.[Abstract/Free Full Text]
Top
References