UniPortal thoracoscopic pneumonectomy does not compromise perioperative and long-term survival in patients with NSCLC: A retrospective, multicenter, and propensity score matching study
| Autor: | Dong Xie, Lihong Qiu, Lei Zhang, Fang Wang, Jiani Gao, Yuming Zhu, Guowei Ma, Chao Li, Xiaomeng Dou, Gening Jiang, Chang Chen, Li Zhixin |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
China Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Pneumonectomy Carcinoma Non-Small-Cell Lung medicine Humans Thoracotomy Propensity Score Retrospective Studies Thoracic Surgery Video-Assisted Proportional hazards model business.industry Mortality rate Hazard ratio Perioperative Surgery Treatment Outcome Oncology Cohort Propensity score matching business |
| Zdroj: | Lung Cancer. 159:135-144 |
| ISSN: | 0169-5002 |
| Popis: | Objectives To compare the perioperative and oncologic outcomes following pneumonectomy performed by uniportal video-assisted thoracoscopic surgery (U-VATS) and thoracotomy in patients with centrally located non–small cell lung cancer (NSCLC). Materials and methods Patients with NSCLC who underwent pneumonectomy at the Shanghai Pulmonary Hospital (SPH) and Sun Yat-sen University Cancer Center (SYUCC) with the U-VATS approach or open approach between 2011 and 2016 were selected. Propensity score matching (1:3) was performed to balance the baseline covariates. Overall survival (OS) rates and recurrence-free survival (RFS) rates were estimated and compared using the Kaplan–Meier method, respectively. Results The enrollees in the study were 579 patients in the SPH cohort, with 501 (86.5%) in the open group and 48 (13.5%) in the U-VATS group, and 271 patients in the SYUCC cohort, with 245 (90.4%) in the open group and 26 (9.6%) in the U-VATS group. After propensity score matching, morbidity rates and 30-day mortality rates were found to be similar between the U-VATS group and open group in both the SPH and SYUCC cohorts. The long-term OS rate of patients who underwent U-VATS pneumonectomy did not significantly differ compared with the patients who underwent open pneumonectomy in both cohorts (SPH, p = .900; SYUCC, p = .240). Cox regression analysis revealed that the surgical option was not a risk factor for the OS rate (SPH: hazard ratio [HR], 0.925; 95% confidence interval [CI], 0.555 to 1.542; SYUCC: HR, 1.524; 95% CI, 0.752 to 3.087). Conclusion U-VATS can be used to safely perform pneumonectomy in patients with centrally located NSCLC without compromising the perioperative and oncologic outcomes compared with an open approach. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect