To compare the effects of lobectomy on immunologic function between video-assisted thoracoscopic surgery (VATS) and traditional open surgery (TOS) for non-small-cell lung cancer (NSCLC). A total of 80 patients with NSCLC were recruited from Liaoning Cancer Hospital & Institute between June 2013 and August 2014. The participators were grouped into VATS and TOS at random. The levels of C-reactive protein, serum amyloid A, interleukin (IL) 6, and IL-2R were detected before operation, 24 hours, and 72 hours after operation. The number of peripheral blood lymphocytes and the proportion of CD4 T lymphocytes, CD8 T lymphocytes, and natural killer in lymphocytes of all patients should be detected before operation, 3 days, and 7 days after operation. The preoperative and postoperative quality of life assessment of patients with NSCLC was evaluated. All data were analyzed using SPSS 17.0 software. The blood loss and transfusion volume during operation in VATS group were obviously less than those in TOS group. The levels of CPR, serum amyloid A, IL-6, and IL-2R after operation were significantly higher as compared with those before operation. The postoperative proportions of CD4 T lymphocytes and natural killer in lymphocytes and the number of lymphocytes were decreased compared with those before operation. The proportion of CD8 T lymphocytes 7 days after operation in TOS group was clearly lower than that in VATS group. The postoperative quality of life was evidently higher compared with that after operation in VATS and TOS groups. In conclusion, when compared with TOS, VATS could decrease perioperative acute-phase reaction, lighten the restrain of immunologic function, and improve quality of life in patients with early-stage NSCLC, suggesting that VATS lobectomy is an appropriate method for patients with early-stage NSCLC as compared with TOS.

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Background The safety and effectiveness of lung segmentectomy in patients with early non-small cell lung cancer (NSCLC) remains controversial. We have therefore reviewed the clinicopathologic characteristics and survival outcomes of patients treated with lobectomy or segmentectomy for early T (> 2 and ≤ 3 cm) N0M0 NSCLC. Methods We obtained data from the Surveillance, Epidemiology, and End Results database for patients who underwent lobectomy or segmentectomy between 2004 and 2015. To reduce bias and imbalances between the treatment groups, propensity score matching analysis was performed. We used Kaplan–Meier curves to estimate overall survival (OS) and lung cancer-specific survival (LCSS). We conducted univariate and multivariate Cox proportional hazards regression analyses to identify independent prognostic factors for OS and cancer-specific survival, and applied the Cox proportional hazards model to create forest plots. Results Before matching, both univariate and multivariate Cox regression analyses revealed that patients who underwent lobectomy exhibited better OS (P < 0.001) and LCSS (P = 0.001) than patients who underwent segmentectomy. However, after matching, survival differences between the groups were not significant; OS (P = 0.434) and LCSS (P = 0.593). Regression analyses revealed that age and tumor grade were independent predictors of OS and LCSS (P < 0.05). Conclusions Patients with stage T (> 2 and ≤ 3 cm) N0M0 NSCLC undergoing segmentectomy can obtain OS and LCSS similar to those obtained with lobectomy. Further studies are required considering the solid component effects and pathologic tumor types regarding segmentectomies. Additional long-term survival and outcome analyses should be conducted with larger cohorts.

Background:Surgery is established as the most effective treatment for central lung cancer. Minimally invasive surgery (MIS) is gaining popularity. The decision of whether surgical treatment of central lung cancer should be minimally invasive or a conventional thoracotomy is a critical decision for the thoracic surgeon. However, whether MIS is more advantageous than other surgical treatments for central lung cancer. This study aimed to compare the short-and long-term results of MIS and conventional thoracotomy in patients with central lung cancer. Methods:This meta-analysis was conducted using the PubMed, Embase, Wiley Online Library, Google Scholar, Wanfang, and China National Knowledge Infrastructure databases. Searches for relevant studies were conducted in strict accordance with research protocols detailed in the Cochrane handbook. The primary endpoints for comparison between the two surgical methods were perioperative and long-term survival. A 95% confidence interval (CI) for relative risk (RR)/mean difference (MD) was calculated to assess the strength of the correlation. Results:Nine studies that met the inclusion and exclusion criteria were eventually included in this meta-analysis. These studies involved a total of 5,869 patients [MIS, n =1,140 versus thoracotomy (TH), n =4,729]. The 3-and 5-year disease-free survival (DFS) and the 2-, 3-, and 5-year overall survival (OS) were similar for the MIS and TH groups [OR: 0.