Patterns of recurrence and incidence of second primary tumors after lobectomy by means of video-assisted thoracoscopic surgery (VATS) versus thoracotomy for lung cancer Journal Article
| Authors: | Flores, R. M.; Ihekweazu, U. N.; Rizk, N.; Dycoco, J.; Bains, M. S.; Downey, R. J.; Adusumilli, P.; Finley, D. J.; Huang, J.; Rusch, V. W.; Sarkaria, I.; Park, B. |
| Article Title: | Patterns of recurrence and incidence of second primary tumors after lobectomy by means of video-assisted thoracoscopic surgery (VATS) versus thoracotomy for lung cancer |
| Abstract: | Objective: Reports have questioned the oncologic efficacy of video-assisted thoracoscopic surgery when compared with thoracotomy despite similar survival results. In response, we investigated the pattern of recurrent disease and the incidence of second primary tumors after lobectomy by means of video-assisted thoracoscopic surgery and thoracotomy. Methods: All patients who underwent lobectomy for clinical stage IA lung cancer determined by means of computed tomographic and positron emission tomographic analysis were identified from a prospective database at a single institution. All patients were selected for video-assisted thoracoscopic surgery or thoracotomy by an individual surgeon. Patients' characteristics, perioperative results, recurrences, and second primary tumors were recorded. Variables were compared by using Student's t test, the Pearson χ2 test, and Fisher's exact test. A logistic regression model was constructed to identify variables influencing the development of recurrent disease or metachronous tumors. Results: From 2002 to 2009, 520 patients underwent lobectomy by means of video-assisted thoracoscopic surgery, and 652 underwent lobectomy by means of thoracotomy. Final pathological stage was similar in the video-assisted thoracoscopic surgery and thoracotomy groups. Logistic regression demonstrated a lower risk (odds ratio, 0.65; P = .01) of recurrent disease in patients undergoing video-assisted thoracoscopic surgery after adjusting for age, stage, sex, histology, tumor location, and synchronous primary tumors. Conclusions: Recurrence rates for video-assisted thoracoscopic surgery appear to be at least equivalent to those for thoracotomy. This study supports lobectomy by means of video-assisted thoracoscopic surgery as an oncologically sound technique. |
| Keywords: | adult; cancer survival; controlled study; treatment outcome; primary tumor; surgical technique; major clinical study; histopathology; cancer recurrence; cancer staging; outcome assessment; positron emission tomography; cancer incidence; prospective study; computer assisted tomography; thoracotomy; lung cancer; surgical approach; intermethod comparison; perioperative period; logistic regression analysis; lobectomy; fisher exact test; vats; video assisted thoracoscopic surgery; student t test; video-assisted thoracoscopic surgery; chi square distribution |
| Journal Title: | Journal of Thoracic and Cardiovascular Surgery |
| Volume: | 141 |
| Issue: | 1 |
| ISSN: | 0022-5223 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2011-01-01 |
| Start Page: | 59 |
| End Page: | 64 |
| Language: | English |
| DOI: | 10.1016/j.jtcvs.2010.08.062 |
| PROVIDER: | scopus |
| PUBMED: | 21055770 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 4 March 2011" - "CODEN: JTCSA" - "Source: Scopus" |
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