P3.16-34 The Impact of Preoperative Exercise Therapy on the Surgical Outcomes of Patients with Lung Cancer and COPD: A Systematic Review and Meta-Analysis

Abstract

performed segmentectomy for compromised patients, and patients with small-sized NSCLC and adequate pulmonary function for curative intent. The aim of this study was to investigate first recurrence sites and risk factors of recurrence in NSCLC patients who underwent segmentectomy. Method: We retrospectively reviewed 136 patients with clinical stage I NSCLC (the 7th edition of the TNM classification) who underwent segmentectomy at Niigata University Medical and Dental Hospital between 2000 and 2016. We investigated first recurrence site to classify as intrathoracic or extrathoracic recurrence. The significant demographic, clinical, and pathologic factors identified with the log rank test in univariate analyses were analyzed with the Cox proportional hazards regression model to examine independent predictors for recurrence in multivariate analysis. For the significant predictor, we determined optimal cutoff points by receiver operating characteristic (ROC) analysis and Youden's Index Result: Of the 136 patients in this study, 81 were male and 55 were female, and the median age was 71 years (range, 41 to 86 years). During the median follow-up period of 1568 days (range, 15 to 6584 days), recurrence was developed in 11 patients. Intrathoracic recurrence was developed only in 4 patients, including 2 patients with surgical resection margin recurrence. The 5-and 10-year recurrence-free probabilities were 89.7% and 89.7%, respectively. Solid tumor component size on computed tomography (CT) was identified as an independent significant predictor (hazard ratio [HR], 3.459). To illustrate ROC curve and use Youden's Index, the optimal cutoff points were determined as 1.5 cm for solid component size on CT. Conclusion: In the study, the NSCLC patients with solid component of larger than 1.5 cm on CT had a higher risk for postoperative recurrence after segmentectomy. However it is still unknown whether these patients could be cured by lobectomy, because many of the patients with postoperative recurrence had extrathoracic recurrence.