NSCLC: robotic lobectomy similarly effective to VATS, open surgery

  • Clin Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Robotic-assisted lobectomy yields similar operative, oncologic, and survival outcomes as video-assisted thoracoscopic surgery (VATS) and open thoracotomy in the treatment of early NSCLC.

Why this matters

  • Minimally invasive techniques are preferred, and this study clarifies long-term outcomes.

Study design

  • 540 patients with NSCLC underwent lobectomy by robotic (n=250) and VATS (n=126) or open thoracotomy (n=164) approach.
  • Median follow-up, 44.8 months.
  • Funding: None.

Key results

  • Intraoperative conversion rates were similar between the robotic (9.2%) and VATS (9.5%) groups.
  • No significant differences were seen between groups in complete R0 resection or in average total number of lymph nodes resected.
  • OS and recurrence-free survival for the entire cohort, respectively:
    • 3 years: 75% (95% CI, 71%-79%) and 64% (95% CI, 59%-68%).
    • 5 years: 64% (95% CI, 58%-59%) and 54% (95% CI, 49%-59%).
  • No significant difference in OS between robotic and VATS (aHR, 1.39; 95% CI, 0.82-2.36) or open thoracotomy (aHR, 0.94; 95% CI, 0.61-1.45).
  • Similar incidence of locoregional recurrence (robotic, 7%; VATS, 6%; open, 8%, P=.09) and distant failure (14%, 18%, 17%, P=.9).
  • No significant difference in recurrence-free survival for VATS (aHR, 1.50; 95% CI, 0.96-2.34) or open thoracotomy (aHR, 1.07; 95% CI, 0.73-1.57) vs robotic lobectomy.

Limitations

  • Retrospective, single-center study.