Pulmonary Open, Robotic, and Thoracoscopic Lobectomy (PORTaL) Study: Survival Analysis of 6646 Cases.

Autor:	Kent MS; Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Hartwig MG; Division of Thoracic Surgery, Duke University, Durham, NC., Vallières E; Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, WA., Abbas AE; Division of Thoracic Surgery, Temple University Health System, Philadelphia, PA., Cerfolio RJ; Division of Thoracic Surgery, NYU Langone, New York, NY., Dylewski MR; General Thoracic Surgery, Baptist Health Medical Group, South Miami, FL., Fabian T; Division of Thoracic Surgery, Albany Medical Center, Albany, NY., Herrera LJ; Rod Taylor Thoracic Care Center, Orlando Health UF Health Cancer Center, Orlando FL., Jett KG; Division of Thoracic Surgery, Baylor Scott & White The Heart Hospital-Plano, Plano, TX., Lazzaro RS; Department of Cardiothoracic Surgery, Northwell Health, New York, NY., Meyers B; Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO., Reddy RM; Division of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, MI., Reed MF; Division of Thoracic Surgery, Penn State Cancer Institute, Hershey, PA., Rice DC; Department of Thoracic and Cardiovascular Surgery, The University of Texas M.D. Anderson Cancer, Houston, TX., Ross P; Main Line Health Care Thoracic Surgery, Main Line Health, Wynewood, PA., Sarkaria IS; Division of Thoracic Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA., Schumacher LY; Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA., Spier LN; Department of Cardiothoracic Surgery, Northwell Health, New York, NY., Tisol WB; Division of Thoracic Surgery, Aurora Health Care, Grafton, MI., Wigle DA; Division of General Thoracic Surgery, Mayo Clinic, Rochester, MN., Zervos M; Division of Thoracic Surgery, NYU Langone, New York, NY.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2023 Jun 01; Vol. 277 (6), pp. 1002-1009. Date of Electronic Publication: 2023 Feb 10.
DOI:	10.1097/SLA.0000000000005820
Abstrakt:	Objective: The aim of this study was to analyze overall survival (OS) of robotic-assisted lobectomy (RL), video-assisted thoracoscopic lobectomy (VATS), and open lobectomy (OL) performed by experienced thoracic surgeons across multiple institutions. Summary Background Data: Surgeons have increasingly adopted RL for resection of early-stage lung cancer. Comparative survival data following these approaches is largely from single-institution case series or administrative data sets. Methods: Retrospective data was collected from 21 institutions from 2013 to 2019. Consecutive cases performed for clinical stage IA-IIIA lung cancer were included. Induction therapy patients were excluded. The propensity-score method of inverse-probability of treatment weighting was used to balance baseline characteristics. OS was estimated using the Kaplan-Meier method. Multivariable Cox proportional hazard models were used to evaluate association among OS and relevant risk factors. Results: A total of 2789 RL, 2661 VATS, and 1196 OL cases were included. The unadjusted 5-year OS rate was highest for OL (84%) followed by RL (81%) and VATS (74%); P =0.008. Similar trends were also observed after inverse-probability of treatment weighting adjustment (RL 81%; VATS 73%, OL 85%, P =0.001). Multivariable Cox regression analyses revealed that OL and RL were associated with significantly higher OS compared with VATS (OL vs. VATS: hazard ratio=0.64, P <0.001 and RL vs. VATS: hazard ratio=0.79; P =0.007). Conclusions: Our finding from this large multicenter study suggests that patients undergoing RL and OL have statistically similar OS, while the VATS group was associated with shorter OS. Further studies with longer follow-up are necessary to help evaluate these observations. Competing Interests: A.E.A.: Consultant, Intuitive Surgical. R.J.C.: Consultant, Intuitive Surgical. M.R.D.: Consultant for Intuitive Surgical and Verb Surgical, Clinical Education Ethicon. L.J.H.: Consultant, Intuitive Surgical. K.G.J.: Consultant, Intuitive Surgical. M.S.K.: Speaker, Intuitive Surgical. R.M.R.: Consultant for Intuitive Surgical and Auris Health, Advisory Board Medtronic. P.R.: Consultant, Intuitive Surgical. I.S.S.: Consultant, Intuitive Surgical. L.Y.S.: Proctor, Intuitive Surgical. W.B.T.: Consultant, Intuitive Surgical. The remaining authors report no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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