Long‐term patient outcome 10 years after video‐assisted thoracoscopic surgery lobectomy for non‐small‐cell lung cancer

Abstract

Introduction: Although there have been many reports associating video‐assisted thoracoscopic surgery (VATS) with improved survival rates in early lung cancer, almost all of the reports have involved short median follow‐ups and been presented at a 5‐year point. Here, we establish the pattern and frequency of recurrences, as well as the long‐term survival rates of patients who have undergone VATS more than 10 years ago. Methods: We retrospectively studied 41 patients who underwent VATS lobectomy for clinical stage I non‐small‐cell lung cancer at Fukuoka University Hospital between November 1994 and December 1999. All patients underwent lobectomy, including a dissection of hilar and mediastinal lymph nodes. Follow‐up consisted of clinical and radiological examinations every 3 months for the first 2 years after the surgery and then once a year thereafter. Results: Of the 41 patients, 31 were diagnosed to be at pathologic stage IA and six at stage IB, while the remaining four were more advanced cases. During the follow‐up period, recurrences were found in five cases (12.2%). Four patients with recurrence died of lung cancer and an additional two died from cancers of other organs. There were other non‐cancer related deaths, largely from respiratory failures. Overall, the 5‐ and 10‐year survival rates after the operation were 79.8% and 68.8%, respectively. Conclusion: Long‐term survival and recurrence rates after a classic VATS lobectomy for lung cancer are favorable compared to the conventional approach.

Long-term survival of thoracoscopic surgery compared with open surgery for clinical N0 adenocarcinoma

“…was equivalent to open lobectomy (2)(3)(4), however, VATS lobectomy is not a same operation as an open lobectomy. As previously reported, nodal upstaging under VATS was lower than open procedure from Danish Data Base (5), STS Data Base (6) and National Cancer Data Base (7).…”

“…The most of previous reports are retrospective analyses which provide a definitive evidence to compare short-term outcome and median duration of survival (2)(3)(4).…”

Postoperative pain in thoracic surgery: re-evaluating the benefits of VATS when coupled with epidural analgesia

“…In fact, at our institutions as well, even many high-risk patients, such as elderly patients or hemodialysis patients, have undergone VATS lobectomy (10,11). Over the years VATS technology and techniques have been dramatically refined, to the point that most people are no longer concerned about its potential risks.…”

“…It has shown steady technical progress, including uniportal VATS lobectomy (17), owing to the enthusiastic dedication to the procedure throughout Japan (1,3,4,10). Its cosmetic merits are particularly advantageous for young patients as well.…”

How to manage tumor located between upper division and lingular segment “S3+S4 segmentectomy and S3b+S4 segmentectomy”

“…VATS showed better or at least equivalent outcomes regarding intra-or postoperative complications compared with thoracotomy, with less invasiveness (2). Additionally, long-term survival by VATS lobectomy was suggested to be at least equivalent to open lobectomy (3). Lobectomy is still gold standard for treatment of early stage lung cancer, however, segmentectomy is a treatment of choice for small-sized lung cancer.…”