Daniel Hernandez-Vaquero1, Carlota Vigil-Escalera2, Itzell Pérez-Méndez3, Alexia Gutiérrez3, Pablo Avanzas4, Yinghui Wei5, Rocio Diaz6, Jacobo Silva4, Cesar Moris4, Isaac Pascual4. 1. Institute of Research of The Principado de Asturias, Oviedo, Spain; Department of Medicine. University of Oviedo. Oviedo, Spain; Department of Cardiac Surgery. Central University Hospital of Asturias. Oviedo, Spain. Electronic address: dhvaquero@gmail.com. 2. Department of Cardiac Surgery. Central University Hospital of Asturias. Oviedo, Spain. 3. Department of Thoracic Surgery. Central University Hospital of Asturias. Oviedo, Spain. 4. Institute of Research of The Principado de Asturias, Oviedo, Spain; Department of Medicine. University of Oviedo. Oviedo, Spain. 5. School of Engineering, Computing and Mathematics, University of Plymouth, UK. 6. Institute of Research of The Principado de Asturias, Oviedo, Spain; Department of Medicine. University of Oviedo. Oviedo, Spain; Department of Cardiac Surgery. Central University Hospital of Asturias. Oviedo, Spain.
Abstract
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) has shown to reduce hospital stay and pain compared with and open lobectomy to treat non-small cell lung cancer (NSCLC). Due to the low rate of deaths, it is difficult to show differences in survival in individual works. Our objective was to compare short and long-term mortality developing a systematic review and meta-analysis. METHODS: We systematically searched studies that compared VATS versus open lobectomy and provided data on 30-day mortality or long-term survival (>5 years). For long-term outcomes, studies must include patients with the same cancer stage or, if several stages were included, the studies had to control for cancer stage in their PS model. A pooled OR and HR was respectively calculated for short and long-term outcomes. RESULTS: 33 works were identified comprising 61633 patients. VATS led to lower postoperative mortality, OR=0.64 (CI 95% 0.56-0.73) and higher long-term survival, HR=0.88 (CI 95% 0.81-0.96). Disease-free survival was similar: HR=0.94 (CI 95% 0.80-1.10). CONCLUSIONS: For NSCLC treated with lobectomy, VATS is associated with lower postoperative mortality and greater long-term survival. Disease-free survival is similar between both groups.
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) has shown to reduce hospital stay and pain compared with and open lobectomy to treat non-small cell lung cancer (NSCLC). Due to the low rate of deaths, it is difficult to show differences in survival in individual works. Our objective was to compare short and long-term mortality developing a systematic review and meta-analysis. METHODS: We systematically searched studies that compared VATS versus open lobectomy and provided data on 30-day mortality or long-term survival (>5 years). For long-term outcomes, studies must include patients with the same cancer stage or, if several stages were included, the studies had to control for cancer stage in their PS model. A pooled OR and HR was respectively calculated for short and long-term outcomes. RESULTS: 33 works were identified comprising 61633 patients. VATS led to lower postoperative mortality, OR=0.64 (CI 95% 0.56-0.73) and higher long-term survival, HR=0.88 (CI 95% 0.81-0.96). Disease-free survival was similar: HR=0.94 (CI 95% 0.80-1.10). CONCLUSIONS: For NSCLC treated with lobectomy, VATS is associated with lower postoperative mortality and greater long-term survival. Disease-free survival is similar between both groups.
Authors: Brendan T Heiden; Emmanuel Tetteh; Keenan J Robbins; Rachel G Tabak; Ruben G Nava; Gary F Marklin; Daniel Kreisel; Bryan F Meyers; Benjamin D Kozower; Virginia R McKay; Varun Puri Journal: Ann Thorac Surg Date: 2021-09-06 Impact factor: 5.102