Long-term survival based on the surgical approach to lobectomy for clinical stage I nonsmall cell lung cancer: Comparison of robotic, video-assisted thoracic surgery, and thoracotomy lobectomy Journal Article
| Authors: | Yang, H. X.; Woo, K. M.; Sima, C. S.; Bains, M. S.; Adusumilli, P. S.; Huang, J.; Finley, D. J.; Rizk, N. P.; Rusch, V. W.; Jones, D. R.; Park, B. J. |
| Article Title: | Long-term survival based on the surgical approach to lobectomy for clinical stage I nonsmall cell lung cancer: Comparison of robotic, video-assisted thoracic surgery, and thoracotomy lobectomy |
| Abstract: | Objective: To compare the long-term outcomes among robotic, video-assisted thoracic surgery (VATS), and open lobectomy in stage I nonsmall cell lung cancer (NSCLC). Background: Survival comparisons between robotic, VATS, and open lobectomy in NSCLC have not yet been reported. Some studies have suggested that survival after VATS is superior, for unclear reasons. Methods: Three cohorts (robotic, VATS, and open) of clinical stage I NSCLC patients were matched by propensity score and compared to assess overall survival (OS) and disease-free survival (DFS). Univariate and multivariate analyses were performed to identify factors associated with the outcomes. Results: From January 2002 to December 2012, 470 unique patients (172 robotic, 141 VATS, and 157 open) were included in the analysis. The robotic approach harvested a higher number of median stations of lymph nodes (5 for robotic vs 3 for VATS vs 4 for open; P < 0.001). Patients undergoing minimally invasive approaches had shorter median length of hospital stay (4 d for robotic vs 4 d for VATS vs 5 d for open; P < 0.001). The 5-year OS for the robotic, VATS, and open matched groups were 77.6%, 73.5%, and 77.9%, respectively, without a statistically significant difference; corresponding 5-year DFS were 72.7%, 65.5%, and 69.0%, respectively, with a statistically significant difference between the robotic and VATS groups (P = 0.047). However, multivariate analysis found that surgical approach was not independently associated with shorter OS and DFS. Conclusions: Minimally invasive approaches to lobectomy for clinical stage I NSCLC result in similar long-term survival as thoracotomy. Use of VATS and robotics is associated with shorter length of stay, and the robotic approach resulted in greater lymph node assessment. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. |
| Keywords: | thoracotomy; minimally invasive surgery; lobectomy; nonsmall cell lung cancer; video-assisted thoracic surgery; robotic procedure |
| Journal Title: | Annals of Surgery |
| Volume: | 265 |
| Issue: | 2 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2017-02-01 |
| Start Page: | 431 |
| End Page: | 437 |
| Language: | English |
| DOI: | 10.1097/sla.0000000000001708 |
| PROVIDER: | scopus |
| PMCID: | PMC5033685 |
| PUBMED: | 28059973 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 February 2017 -- Source: Scopus |
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