NSCLC: robotic-assisted surgery bests open thoracotomy

  • Veluswamy RR & al.
  • Chest
  • 4 Oct 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Robotic-assisted surgery (RAS) offered significantly lower surgical complication rates compared with open thoracotomy in older patients with stage I-IIIA NSCLC, with similar survival rates and adequate lymph node staging.
  • RAS offered similar outcomes as video-assisted thoracic surgery (VATS).

Why this matters

  • Open lobectomy has been the standard surgical approach for resectable stage I-IIIA NSCLC.

Study design

  • 2766 patients with stage I-IIIA NSCLC treated with RAS (n=338), VATS (n=1230), or open thoracotomy (n=1198).
  • Funding: American Society of Clinical Oncology and others.

Key results

  • Overall surgical complication rates were lower with RAS than open thoracotomy (OR, 0.57; 95% CI, 0.42-0.79).
  • There was no statistical difference between RAS and open thoracotomy in adequate lymph node staging (OR, 1.28; 95% CI, 0.94-1.74) and exploratory survival analyses (HR for OS, 0.81 [95% CI, 0.63-1.04]; and HR for lung cancer-specific survival, 0.75 [95% CI, 0.51-1.12]).
  • VATS and RAS offered similar overall surgical complication rates (OR, 1.02; P>.05) and similar odds of undergoing adequate lymph node evaluation (OR, 0.88; 95% CI, 0.66-1.18) and survival (HR for OS, 0.91 [95% CI, 0.70-1.18] and HR for lung cancer-specific survival, 0.87 [95% CI, 0.56-1.34]).

Limitations

  • Retrospective study.

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