Long-term Survival After Videothoracoscopic Lobectomy for Stage I Lung Cancer

Roviaro, Giancarlo; Varoli, F.; Vergani, Contardo; Nucca, O.; Maciocco, M.; Grignani, F

doi:10.1378/chest.126.3.725

Cited by 130 publications

(65 citation statements)

References 27 publications

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“…In addition, the extended survival may be further exaggerated by the limited number of patients available (44,45). We consi dered that patient bias may be a critical bias, and it should have influence on survival.…”

Section: Discussionmentioning

confidence: 93%

Video-assisted thoracoscopic surgery versus open lobectomy for stage I lung cancer: A meta-analysis of long-term outcomes

Liu

2012

Experimental and Therapeutic Medicine

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Abstract. The present study aimed to evaluate the evidence comparing video-assisted thoracoscopic surgery (VATS) and open lobectomy for the treatment of stage I lung cancer using meta-analytical techniques. A literature search was undertaken until July 2011 to identify comparative studies evaluating survival rates, recurrence rates and complications. Pooled odds ratios (OR) and 95% confidence intervals (95% CI) were calculated with either the fixed-or random-effects model. These studies included a total of 1, IntroductionLung cancer is the most common malignant tumor in the world. With the improvement in diagnostic technology, more and more stage I lung cancer is identified. Video-assisted thoracoscopic surgery (VATS) was first reported by Levi et al in 1990 (1). The inital clinical reports on video-assisted thoracoscopic surgery lobe ctomy, published from 1993 onward, were either preliminary or involved a small number of patients, which indicated the feasibility and safety of VATS lobectomy (2-6). Since then, VATS has become an attractive surgical procedure for benign diseases, due to its low invasiveness (7,8). As the experience with VATS for benign diseases increased, VATS was gradually adopted for the treatment of lung cancer. Thereafter, VATS lobectomy for elderly patients and series involving a larger number of patients were reported (9-14). VATS lobectomy is now accepted, if not universally, at least as an alternative surgical option for early-stage lung cancer.The advantages of VATS lobectomy, which include less pain and better pulmonary function in the early postoperative period, have been previously reported. However, there are various controversies regarding the prognosis of VATS vs. open lobectomy for stage I lung cancer. Immune system function in the early postoperative period was found to be better preserved in patients who underwent VATS lobectomy. Curability after VATS lobectomy was also reported to be similar to the generally accepted curability rate after open lobectomy. Several investigators reported that the survival rate after VATS lobectomy was similar to that after open lobectomy. Sawada et al (15), Sugiura et al (16), Tashima et al (17) and Flores et al (18) reported that there was no statistically significant difference in survival between the VATS and open lobectomy in early-stage lung cancer. However, this meta-analysis showed that VATS had significantly better survival rates in terms of overall survival at 5 years. Materials and methodsStudy selection. Electronic searches were performed of the MEDLINE, Cochrane Controlled Trial Register (CENTRAL) and EMBASE databases until July 2011. The following Mesh search headings were used: (VATS, video-assisted thoracoscopic or video-assisted thoracoscopic surgery), (open or conventional or standard lobectomy), (lung cancer or lung carcinoma), (randomized controlled trials) and (comparative study) in English (Fig. 1).Data extraction and quality assessment. Data were extracted by three independent observers using standardized forms. The rec...

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Section: Discussionmentioning

confidence: 93%

Video-assisted thoracoscopic surgery versus open lobectomy for stage I lung cancer: A meta-analysis of long-term outcomes

Liu

2012

Experimental and Therapeutic Medicine

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“…[90][91][92][93][94] In patients with stage I NSCLC who undergo VATS with lymph node dissection, the 5-year survival, long-term survival, and local recurrence rates were comparable to those achieved with routine open lung resection. [95][96][97] VATS has also been shown to improve discharge independence in older populations and high-risk patients. 98,99 Recent data show that VATS improves the ability of patients to complete postoperative chemotherapy regimens.…”

Section: Surgerymentioning

confidence: 99%

Non–Small Cell Lung Cancer

Ettinger

Akerley

Bepler

et al. 2010

J Natl Compr Canc Netw

604

371

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“…Recently, several advantages of VATS lobectomy have been demonstrated with respect to postoperative clinical findings and prognosis [8,9]. In the present study, significant differences among the three surgical approaches were seen for blood loss, operation time, drainage period (data not shown) and hospital stay.…”

Section: Discussionmentioning

confidence: 45%

Pulmonary function after pulmonary resection by posterior thoracotomy, anterior thoracotomy or video-assisted surgery

Endoh

Tanaka

Yajima

et al. 2010

European Journal of Cardio-Thoracic Surgery

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Objective: Predicted postoperative forced expiratory volume in 1 s (ppoFEV1) is estimated in lung cancer patients before pulmonary resection, as well as the clinical stage. This study aims to evaluate ppoFEV1 and ppo-vital capacity (ppoVC) on postoperative day 7 (POD7) and to compare the results following video-assisted thoracic surgery (VATS) and open thoracotomy procedures. Methods: Of the 155 patients who underwent pulmonary resection, 70 had VATS; 30 had muscle-sparing thoracotomy (anterior limiting thoracotomy (AL)); and 55 had postero-lateral thoracotomy (PL). VC and FEV1 were measured on POD7 and compared with the VC and FEV1 before surgery using analysis of covariance (ANCOVA). The ratio of the actual-and the ppoVC and FEV1 was evaluated to identify factors associated with variations in postoperative residual VC/FEV1. Results: There were significant differences by analysis of covariance (ANCOVA) in the VC/FEV1 among the three surgical approaches. In the VATS group, the VC ratio and the FEV1 ratio were 96.5% and 94.7%, respectively; they were significantly higher in the VATS group than in the thoracotomy group (AL: 90.4% and 90.1%, respectively; PL: 87.4% and 87.6%, respectively). Non-chronic obstructive pulmonary disease (COPD) and upper lobectomy were also associated with a low VC ratio and FEV1 ratio. Conclusion: Predicted postoperative pulmonary function might be overestimated in COPD patients or in those undergoing VATS or lower lobectomy. #

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Long-term Survival After Videothoracoscopic Lobectomy for Stage I Lung Cancer

Cited by 130 publications

References 27 publications

Video-assisted thoracoscopic surgery versus open lobectomy for stage I lung cancer: A meta-analysis of long-term outcomes

Video-assisted thoracoscopic surgery versus open lobectomy for stage I lung cancer: A meta-analysis of long-term outcomes

Non–Small Cell Lung Cancer

Pulmonary function after pulmonary resection by posterior thoracotomy, anterior thoracotomy or video-assisted surgery

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