NSCLC: VATS sleeve lobectomy yields easier recovery, similar efficacy

  • Gao HJ & al.
  • Ann Thorac Surg
  • 1 Jun 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients who underwent video-assisted thoracic surgery (VATS) sleeve lobectomy for centrally located NSCLC had less blood loss and a shorter postoperative stay compared with patients who received thoracotomy, with similar recurrence-free survival (RFS) and OS.

Why this matters

  • Although the use of VATS sleeve lobectomy is increasing, studies comparing outcomes with thoracotomy are lacking.

Study design

  • 148 patients with centrally located NSCLC underwent VATS sleeve lobectomy (n=54) or thoracotomy sleeve lobectomy (n=94).
  • Propensity matching of 39 patient pairs.
  • Median follow-up, 44.0 months.
  • Funding: None disclosed.

Key results

  • In the total cohort, VATS patients had significantly better RFS (3-year, 64.8% vs 45.7% and 5-year, 59.3% vs 44.7%; P=.025) and OS (3-year, 81.5% vs 64.9% and 5-year, 72.2% vs 61.7%; P=.026) compared with the thoracotomy group.
  • After propensity matching, RFS (50.9% vs 48.7%; P=.445) and OS (79.5% vs 66.7%; P=.198) were not significantly different. 
  • No significant differences between groups in 30-day mortality.
  • After propensity matching, VATS patients had significantly less blood loss (228 vs 246 mL; P=.022) and shorter thoracic drainage period (4.6 vs 6.8 days; P<.001 and postoperative hospital stay vs days p=".033)," but a longer operation duration minutes>

Limitations

  • Retrospective study.