P1.16-34 The Impact of Pathology, Staging and Operative Resection on Survival and CT Evidence of Recurrence of Early NSCLC

Abstract

672 VATS lobectomies were performed for the primary treatment of clinical stage I and II NSCLC, 43 patients with ground glass opacity or complex cases were excluded. Patients were analyzed according to ports used (one or multiple), R status, lobe-specific lymphadenectomy, subcarinal lymphadenectomy, length of hospital stay and length of thoracic drainage. A propensity-matched analysis was planned however, all variables were evenly distributed in both groups. Result: Of 629 VATS lobectomies, 234 (37%) were performed with U-VATS and 395 (63%) with M-VATS. Most resections were classified as R(un) (84%); 2% were incomplete. When compared with M-VATS, U-VATS was associated with superior completeness of resection (p¼0.0159), superior lobe-specific lymphadenectomy (p¼0.0004), and superior subcarinal lymphadenectomy (p¼0.0064). The highest mediastinal lymph node station dissected was not different between the approaches. The patients who underwent U-VATS had shorter hospital stays (mean: 4.4 days vs 6.2 days, p¼0.0001) and less thoracic drainage (mean: 4.7 days vs 5.8 days, p¼0.0004). There was no difference in operative mortality (p¼0.3024) ( Table 1). Conclusion: In our institution, most VATS lobectomies were uncertain resections due to the lymph node evaluation by IASLC definition. Using U-VATS is not inferior to M-VATS in accomplishing a complete oncologic resection thoracoscopically. Keywords: non small cell lung cancer, early stage lung cancer, complete resection

Comparison of single utility port video-assisted thoracoscopic surgery (VATS) and three-port VATS for non-small cell lung cancer

“…An important indicator of successful operation in radical surgery for lung cancer is the hilar mediastinal lymphadenectomy. Effective removal of the hilar and mediastinal lymph nodes during surgery can not only provide reference for postoperative pathological staging, but also affect the prognosis of patients (21,22). The results of Chang et al (23) showed that the total number of single utility port or double-port VATS lymph node dissection was similar.…”