NSCLC: long-term quality of life worse with VATS vs thoracotomy

  • Clin Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with NSCLC who underwent lung resection via minimally invasive video-assisted thoracic surgery (VATS) reported worse long-term health-related QoL than patients who underwent thoracotomy.

Why this matters

  • VATS is considered the standard of care for early-stage NSCLC, and has demonstrated similar oncologic outcomes with lower rates of postoperative morbidity/mortality vs thoracotomy.

Study design

  • 180 patients with NSCLC underwent VATS (n=92) or thoracotomy (n=88).
  • Questionnaire was received in July 2011 for patients who underwent surgery during January 2006 to June 2009, and in May 2016 for patients treated between July 2009 and January 2013.
  • Minimum follow-up of 2 years.
  • Funding: Finnish Anti-Tuberculosis Association; others.

Key results

  • Baseline comorbidities and pulmonary function were similar between groups.  
  • Adenocarcinoma (81.5% vs 59.1%; P=.006) and fewer lymph node stations sampled (P=.004) were more likely in the VATS group.
  • Shorter mean length of hospital stay in the VATS group (6.4 vs 8.7 days; P=.001).
  • VATS patients scored significantly lower on the dimensions of breathing (0.637 vs 0.719; P=.030), speaking (0.942 vs 0.973; P=.046), usual activities (0.746 vs 0.821; P=.030), mental function (0.818 vs 0.917; P=.001), vitality (0.767 vs 0.824; P=.049), and overall QoL (0.809 vs 0.851; P=.028).

Limitations

  • Retrospective design.