Use and Outcomes of Minimally Invasive Lobectomy for Stage I Non-Small Cell Lung Cancer in the National Cancer Data Base
| Autor: | Zhifei Sun, Paul J. Speicher, Matthew G. Hartwig, David H. Harpole, Shakir M. Saud, Thomas A. D'Amico, Brian C. Gulack, Betty C. Tong, Mark W. Onaitis, Mark F. Berry, Chi-Fu Jeffrey Yang |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Population 030204 cardiovascular system & hematology Article 03 medical and health sciences Pneumonectomy Postoperative Complications 0302 clinical medicine Carcinoma Non-Small-Cell Lung Carcinoma medicine Humans Registries Propensity Score education Survival rate Aged Neoplasm Staging Retrospective Studies education.field_of_study Thoracic Surgery Video-Assisted business.industry Incidence Puerto Rico Retrospective cohort study Robotics Perioperative medicine.disease United States Surgery Survival Rate Treatment Outcome Cardiothoracic surgery 030220 oncology & carcinogenesis Propensity score matching Female Cardiology and Cardiovascular Medicine business human activities Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 101:1037-1042 |
| ISSN: | 0003-4975 |
| Popis: | Previous studies have raised concerns that video-assisted thoracoscopic (VATS) lobectomy may compromise nodal evaluation. The advantages or limitations of robotic lobectomy have not been thoroughly evaluated.Perioperative outcomes and survival of patients who underwent open versus minimally-invasive surgery (MIS [VATS and robotic]) lobectomy and VATS versus robotic lobectomy for clinical T1-2, N0 non-small cell lung cancer from 2010 to 2012 in the National Cancer Data Base were evaluated using propensity score matching.Of 30,040 lobectomies, 7,824 were VATS and 2,025 were robotic. After propensity score matching, when compared with the open approach (n = 9,390), MIS (n = 9,390) was found to have increased 30-day readmission rates (5% versus 4%, p0.01), shorter median hospital length of stay (5 versus 6 days, p0.01), and improved 2-year survival (87% versus 86%, p = 0.04). There were no significant differences in nodal upstaging and 30-day mortality between the two groups. After propensity score matching, when compared with the robotic group (n = 1,938), VATS (n = 1,938) was not significantly different from robotics with regard to nodal upstaging, 30-day mortality, and 2-year survival.In this population-based analysis, MIS (VATS and robotic) lobectomy was used in the minority of patients for stage I non-small cell lung cancer. MIS lobectomy was associated with shorter length of hospital stay and was not associated with increased perioperative mortality, compromised nodal evaluation, or reduced short-term survival when compared with the open approach. These results suggest the need for broader implementation of MIS techniques. |
| Databáze: | OpenAIRE |
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