Clinicopathological Analysis Of 44 Cases Of NSCLC With Adjacent Lobe Invasion

Objective: Analyze the selection and prognosis of different surgical methods and prognosis of Non-Small Cell Lung Cancer with adjacent lobe invasion(ALI),to explore the reasonable clinical T stage and to chooce the best surgical method for ALI,so as to guide the clinical work and provide a better treatment plan for the patients with ALI.Methods: A retrospective analysis of 265 lung cancer patients who underwent radical lung cancer surgery at the Affiliated Tumor Hospital of Guangxi Medical University from November 2013 to June 2019,of which 44 patients were petients of lung cancer with adjacent lobe invasion.petients of lung cancer with adjacent lobe invasion were divided into complete fission(ALI-A,27 people)and incomplete fissue(ALI-D,17 people)according to the degree of differentiation of interlobar fissure.Patients at stage T2a、T2b、T3 were set as the control group,and the postoperative survival status were compared,compare the different surgical methods of the two groups of ALI patients.The age,Lymph node metastasis or not,and type of ALI were included in the Cox risk regression model for prognostic analysis.Results:1.The 5-year survival rates of patients in ALI-A group,ALI-D group,T2 a group,T2 b group and T3 group were: 38.9%,72.9%,68.3%,55.5% and 35.8%,respectively.(1)There is no statistical difference between the 5-year overall survival rates of patients in ALI-A group,T2 b group and T3 group(ALI-A group vs T2 b group p=0.08,ALI-A group vs T3 group p=0.27,p All>0.05);there is a statistically significant difference in the 5-year overall survival rate between ALI-A group,ALI-D group and T2 a group(ALI-A group vs T2 a group p=0.04,ALI-A group vs ALI-Group D,p=0.04,all p<0.05).(2)There is no statistical difference between the 5-year overall survival rate of patients in ALI-D group and T2 a group and T2 b group(ALI-D group vs T2 a group p=0.32,ALI-D group vs T2 b group p=0.25,p All>0.05);the 5-year overall survival rate of the ALI-D group and the ALI-A group and T3 group was statistically different(ALI-A group vs ALI-D group p=0.04,ALI-D group vs T3 group p =0.01,p<0.05).2.There were 44 cases of ALI and 2 cases of left pneumonectomy were not included in the analysis.Among them,29 patients(69.05%)underwent one lobectomy plus adjacent partial lobectomy,and 13 patients underwent right bilobectomy.The 5-year survival rates of the two groups were 59.4% and 37.0%,respectively,P=0.70,with no significant difference.3.Multivariate analysis showed that Lymph node metastasis and type of ALI were independent prognostic factors of ALI.(P=0.019,P=0.028,HR=14.26,7.69,respectively).Conclusion:1.The postoperative survival rate of patients in ALI-A group was similar to that of T2 b group and T3 group,but worse than that of ALI-D group and T2 a group;The postoperative survival rate of patients in ALI-D group was similar to that of T2 a and T2 b group,which was significantly worse than ALI-A group,T3 group The clinical T stage of patients with ALI-A should be revised to T2 b or even T3.2.Because ALI involves more than one lung lobation,in the choice of surgical methods,right double bilobectomy and one lobectomy plus partial partial lobectomy are effective surgical treatments.Right bilobectomy and one lobectomy plus partial lobectomy are effective surgical treatments.3.Lymph node metastasis and ALI-A type are both risk factors that affect the prognosis of ALI.