UniPortal thoracoscopic pneumonectomy does not compromise perioperative and long-term survival in patients with NSCLC: A retrospective, multicenter, and propensity score matching study

Gao, Jiani; Zhang, Lei; Li, Zhixin; Wang, Fang; Qiu, Lihong; Dou, Xiao-Meng; Li, Chao; Zhu, Yuming; Ma, Guowei; Jiang, Gening; Xie, Dong; Chen, Chang

doi:10.1016/j.lungcan.2021.07.013

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…Pneumonectomies were completed by RATS in 47.1% in this cohort. This is lower than the rates in two recent studies comparing cohorts of minimally invasive pneumonectomy to an open approach, reporting 61.5 and 59.4% completion of pneumonectomy by RATS by Gao [29] and Hennon [30]. No doubt that the surgeon's learning curve influences the conversion rate.…”

Section: Conversion To Thoracotomy Learning Curve and Independent Ris...mentioning

confidence: 64%

“…All studies estimated recurrence-free survival results in cohorts selected on mediastinal involvement and not particularly on T stage, which might affect prognosis negatively. Regarding pneumonectomies, Gao [29] and Hennon [30], both compared a minimally invasive approach with open pneumonectomy. Gao found no significant differences in recurrence-free survival (40.3 vs. 42.9%) and overall survival, also after propensity score matching.…”

Section: Local Recurrencementioning

confidence: 99%

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Robot-assisted thoracic surgery for stages IIB–IVA non-small cell lung cancer: retrospective study of feasibility and outcome

et al. 2023

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Robot-assisted thoracic surgery (RATS) for higher stages non-small cell lung carcinoma (NSCLC) remains controversial. This study reports the feasibility of RATS in patients with stages IIB–IVA NSCLC. A single-institute, retrospective study was conducted with patients undergoing RATS for stages IIB–IVA NSCLC, from January 2015 until January 2020. Unforeseen N2 disease was excluded. Data were collected from the Dutch Lung Cancer Audit database. Conversion rate, radical (R0) resection rate, local recurrence rate and complications were analyzed, as were risk factors for conversion. RATS was performed in 95 patients with NSCLC clinical or pathological stages IIB (N = 51), IIIA (N = 39), IIIB (N = 2) and IVA (N = 3). 10.5% had received neoadjuvant chemoradiotherapy. Pathological staging was T3 in 33.7% and T4 in 34.7%. RATS was completed in 77.9% with a radical resection rate of 94.8%. Lobectomy was performed in 67.4% of the total resections. Conversion was for strategic (18.9%) and emergency (3.2%) reasons. Pneumonectomy (p = 0.001), squamous cell carcinoma (p < 0.001), additional resection of adjacent structures (p = 0.025) and neoadjuvant chemoradiation (p = 0.017) were independent risk factors for conversion. Major post-operative complications occurred in ten patients (10.5%) including an in-hospital mortality of 2.1% (n = 2). Median recurrence-free survival was estimated at 39.4 months (CI 16.4–62.5). Two- and 5-year recurrence-free survival rates were 53.8% and 36.7%, respectively. This study concludes that RATS is safe and feasible in higher staged NSCLC tumors after exclusion of unforeseen N2 disease. It brings new perspective on the potential of RATS in higher stages, dealing with larger and more invasive tumors.

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Section: Conversion To Thoracotomy Learning Curve and Independent Ris...mentioning

confidence: 64%

Section: Local Recurrencementioning

confidence: 99%

Robot-assisted thoracic surgery for stages IIB–IVA non-small cell lung cancer: retrospective study of feasibility and outcome

et al. 2023

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“…Digitised approximations of the Kaplan–Meier curves corresponding to two final phase-3 KEYNOTE trial arms (KEYNOTE-42 and KEYNOTE-189) 21 , 22 for pembrolizumab monotherapy and pembrolizumab with chemotherapy used for sensitivity analyses. The purpose being to assess for each of the two regimens the impact of any discrepancy in overall survival between the corresponding clinical trial and RWD cohorts.…”

Section: Methodsmentioning

confidence: 99%

Addressing challenges with real-world synthetic control arms to demonstrate the comparative effectiveness of Pralsetinib in non-small cell lung cancer

et al. 2022

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As advanced non-small cell lung cancer (aNSCLC) is being increasingly divided into rare oncogene-driven subsets, conducting randomised trials becomes challenging. Using real-world data (RWD) to construct control arms for single-arm trials provides an option for comparative data. However, non-randomised treatment comparisons have the potential to be biased and cause concern for decision-makers. Using the example of pralsetinib from a RET fusion-positive aNSCLC single-arm trial (NCT03037385), we demonstrate a relative survival benefit when compared to pembrolizumab monotherapy and pembrolizumab with chemotherapy RWD cohorts. Quantitative bias analyses show that results for the RWD-trial comparisons are robust to data missingness, potential poorer outcomes in RWD and residual confounding. Overall, the study provides evidence in favour of pralsetinib as a first-line treatment for RET fusion-positive aNSCLC. The quantification of potential bias performed in this study can be used as a template for future studies of this nature.

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Outcomes After Neoadjuvant Therapy With or Without Immunotherapy Followed By Pneumonectomy in Non-Small Cell Lung Cancer Patients

Li,

Wu,

Wang

et al. 2024

The Annals of Thoracic Surgery

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UniPortal thoracoscopic pneumonectomy does not compromise perioperative and long-term survival in patients with NSCLC: A retrospective, multicenter, and propensity score matching study

Cited by 5 publications

References 26 publications

Robot-assisted thoracic surgery for stages IIB–IVA non-small cell lung cancer: retrospective study of feasibility and outcome

Robot-assisted thoracic surgery for stages IIB–IVA non-small cell lung cancer: retrospective study of feasibility and outcome

Addressing challenges with real-world synthetic control arms to demonstrate the comparative effectiveness of Pralsetinib in non-small cell lung cancer

Outcomes After Neoadjuvant Therapy With or Without Immunotherapy Followed By Pneumonectomy in Non-Small Cell Lung Cancer Patients

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