Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial

Bendixen, Morten; Jørgensen, Ole Dan; Kronborg, Christian; Andersen, Claus B.; Licht, Peter B.

doi:10.1016/s1470-2045(16)00173-x

Cited by 878 publications

(668 citation statements)

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“…Surgery is considered the best treatment option for early stage lung cancer, and anatomical lobectomy with N1 and at least three N2 stations sampling or dissection has become the standard surgery for early NSCLC patients (3). Minimally invasive video-assisted thoracoscopic lobectomy is also preferred for stage I NSCLC patients (4).…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of stage I NSCLC (≤3 cm) patients following segmentectomy are equivalent to lobectomy under analogous extent of lymph node removal: a PSM based analysis

Qu¹,

Wang²,

Zhang³

et al. 2017

J. Thorac. Dis.

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Background: Segmentectomy has the advantage of less complications, but might have less lymph node sampling and higher risk of recurrence. We aimed to compare treatment outcome between two surgical options, and explore the effect of regional lymph node removal on the prognostic difference. Methods:We retrospectively analyzed data of stage I non-small cell lung cancer (NSCLC) (≤3 cm in size) patients who underwent either segmentectomy, or lobectomy, collected from the Surveillance, Epidemiology and End Results (SEER) database, from 2003 to 2013. The primary endpoints were overall survival (OS) and lung cancer-specific survival (LCSS). We also collected data from Shandong Provincial Hospital as validation.Results: Ultimately 1,156 patients treated by segmentectomy and 17,748 patients treated by lobectomy from SEER database were included in the analysis. Overall, segmentectomy was inferior to lobectomy in terms of OS [hazard ratio (HR): 1.316 (1.186-1.461), P<0.001] and LCSS [HR: 1.310 (1.142-1.504), P<0.001]. When the removal of regional lymph nodes (LN) was taken into consideration, no significant difference was found in OS and LCSS, in any Scope of Regional Lymph Node Surgery layer (0, 1-3, more than 3, and biopsy/sentinel layer, all P>0.05). After propensity score matching (PSM), there was no difference between segmentectomy and lobectomy in OS [HR: 1.081 (0.937-1.248), P=0.286] and LCSS [HR: 1.039 (0.861-1.253), P=0.692]. Only sex, age, histology, summary stage, differentiation, tumor size, and radiation still remained as independent prognostic factors for both OS and LCSS. For validation part, there was no significantly prognostic difference between lobectomy and sublobectomy group in overall (P=0.132) and each regional LN removed layer (0, 1-3, more than 3 layers: all P>0.05).Conclusions: Segmentectomy with proper lymph node resection or sampling could be a good alternative to lobectomy. IntroductionLung cancer is the leading cause of cancer-related death (26.5% of all) and has the second highest annual incidence in both males and females (13.3% for each), in the United States (1). More than half of lung cancer patients (57%) have distant metastasis at diagnosis, and overall 5-year relative survival rate is as low as 18% (1). Lung cancer can be divided into small cell lung cancer (SCLC, less than 20%) and non-small cell lung cancer (NSCLC, more than 80%), with entirely different treatment strategies and prognosis (2). Treatment strategies mainly include surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy (2). Therein, approximately 69% of NSCLC patients with stages I and II are treated by surgery, compared to only 9% of patients with stages III and IV (2). Surgery is considered the best treatment option for early stage lung cancer, and anatomical lobectomy with N1 and at least three N2 stations sampling or dissection has become the standard surgery for early NSCLC patients (3). Minimally invasive video-assisted thoracoscopic lobectomy is also preferred for stage I NSCLC patients (4...

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Section: Introductionmentioning

confidence: 99%

Long-term outcomes of stage I NSCLC (≤3 cm) patients following segmentectomy are equivalent to lobectomy under analogous extent of lymph node removal: a PSM based analysis

Qu¹,

Wang²,

Zhang³

et al. 2017

J. Thorac. Dis.

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show abstract

“…Since the symposium a randomized controlled trial (RCT) has reported on 301 evaluable patients. Videothoracoscopic surgery was associated with less postoperative pain and better quality of life than anterolateral thoracotomy (11).…”

Section: Efficacymentioning

confidence: 90%

Videothoracoscopic resection for lung cancer: moving towards a “standard of care”

Treasure

2016

J. Thorac. Dis.

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“…Recently also randomized controlled studies reported a reduction in postoperative pain, and significantly better self-reported quality of life during the first year after surgery when a minimally invasive approach was used (23). Another rapidly developing and increasingly used technique is singleport (uniportal) VATS, which holds great promises in further reducing surgical access trauma and postoperative discomfort.…”

Section: Advantages Of the Minimally Invasive Approachmentioning

confidence: 99%

Minimally invasive resection and reconstruction of the intrathoracic trachea and carina

Kocher

Dorn

2017

J. Thorac. Dis.

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Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial

Cited by 878 publications

References 25 publications

Long-term outcomes of stage I NSCLC (≤3 cm) patients following segmentectomy are equivalent to lobectomy under analogous extent of lymph node removal: a PSM based analysis

Long-term outcomes of stage I NSCLC (≤3 cm) patients following segmentectomy are equivalent to lobectomy under analogous extent of lymph node removal: a PSM based analysis

Videothoracoscopic resection for lung cancer: moving towards a “standard of care”

Minimally invasive resection and reconstruction of the intrathoracic trachea and carina

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