Hui-Jiang Gao1, Zhi-Hui Jiang2, Lei Gong3, Kai Ma1, Peng Ren3, Zhen-Tao Yu3, Yu-Cheng Wei4. 1. Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China. 2. Department of General Surgery, Qingdao Women and Childrens Hospital, Qingdao, China. 3. Department of Esophageal Cancer, Tianjin's Clinical Research Center for Cancer and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China. 4. Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address: weiyuchengchest@163.com.
Abstract
BACKGROUND: In this retrospective study, we evaluated the safety and efficacy of video-assisted thoracic surgery (VATS) sleeve lobectomy for patients with centrally located non-small cell lung cancer. METHODS: All consecutive patients who received VATS sleeve lobectomy (n = 54) and thoracotomy sleeve lobectomy (n = 94) were analyzed retrospectively; after propensity score matching, 78 paired cases were selected for further statistical analysis. RESULTS: Among all patients, the VATS group showed significantly better recurrence-free survival and overall survival than the thoracotomy group (P = .025 and P = .026, respectively) with smaller total tumor size and earlier pathological tumor-node-metastasis (TNM) stage. Nevertheless, after matching, the recurrence-free survival (50.9% vs 48.7%; P = .445) and overall survival (79.5% vs 66.7%; P = .198) were not significantly different. There was significantly less blood loss (228 vs 246 mL; P = .022), shorter thoracic drainage stay (4.6 vs 6.8 days; P < .001), and postoperative hospital stay (9.2 vs 11.3 days; P = .033) in the VATS group. Multivariate Cox analyses demonstrated that the surgical procedure was not an independent prognostic factor for recurrence-free survival, not only for patients with an invasive component size of 3 cm or less and negative lymphatic invasion, but for locally advanced patients with an invasive tumor size >3 cm (hazard ratio: 0.94; 95% confidence interval: 0.36-2.45; P = .55) or positive lymphatic invasion (hazard ratio: 0.91; 95% confidence interval: 0.35-2.39; P = .41). CONCLUSIONS: VATS sleeve lobectomy is a safe and effective procedure associated with better postoperative recovery and equivalent oncological results, even for locally advanced non-small cell lung cancer patients with an invasive tumor size larger than 3 cm or accompanying lymphatic invasion.
BACKGROUND: In this retrospective study, we evaluated the safety and efficacy of video-assisted thoracic surgery (VATS) sleeve lobectomy for patients with centrally located non-small cell lung cancer. METHODS: All consecutive patients who received VATS sleeve lobectomy (n = 54) and thoracotomy sleeve lobectomy (n = 94) were analyzed retrospectively; after propensity score matching, 78 paired cases were selected for further statistical analysis. RESULTS: Among all patients, the VATS group showed significantly better recurrence-free survival and overall survival than the thoracotomy group (P = .025 and P = .026, respectively) with smaller total tumor size and earlier pathological tumor-node-metastasis (TNM) stage. Nevertheless, after matching, the recurrence-free survival (50.9% vs 48.7%; P = .445) and overall survival (79.5% vs 66.7%; P = .198) were not significantly different. There was significantly less blood loss (228 vs 246 mL; P = .022), shorter thoracic drainage stay (4.6 vs 6.8 days; P < .001), and postoperative hospital stay (9.2 vs 11.3 days; P = .033) in the VATS group. Multivariate Cox analyses demonstrated that the surgical procedure was not an independent prognostic factor for recurrence-free survival, not only for patients with an invasive component size of 3 cm or less and negative lymphatic invasion, but for locally advanced patients with an invasive tumor size >3 cm (hazard ratio: 0.94; 95% confidence interval: 0.36-2.45; P = .55) or positive lymphatic invasion (hazard ratio: 0.91; 95% confidence interval: 0.35-2.39; P = .41). CONCLUSIONS: VATS sleeve lobectomy is a safe and effective procedure associated with better postoperative recovery and equivalent oncological results, even for locally advanced non-small cell lung cancerpatients with an invasive tumor size larger than 3 cm or accompanying lymphatic invasion.
Authors: Angel Cilleruelo-Ramos; Esther Cladellas-Gutiérrez; Carolina de la Pinta; Laura Quintana-Cortés; Paloma Sosa-Fajardo; Felipe Couñago; Xabier Mielgo-Rubio; Juan Carlos Trujillo-Reyes Journal: World J Clin Oncol Date: 2021-12-24