Introduction: This study makes a comparison between stage I non-small cell lung cancer (NSCLC) patients subjected to either robotic-assisted thoracic surgery (RATS), video-assisted tho- racic surgery (VATS) or open thoracotomy, with the aim to evaluate differences between these three approaches in terms of oncological outcomes. Method: We reviewed data from 1367 consecutive patients who, between 2011 and 2017, underwent lobectomy for NSCLC with either open surgery, VATS or RATS, and performed a matched case-control study based on patients’ age, gender, clinical stage (IA, IB) and ASA score. Results: 180 patients (n = 72 RATS, n = 36 VATS, n = 72 open) were ana- lyzed. Complication rates were found to be comparable (72.2% open, 86.1% VATS, 81.9% RATS), with similar grades of severity. The median number of resected lymph nodes was higher in open surgery (n = 22) than in VATS (n = 15; p = 0.0001) and in RATS (n = 17; p = 0.004). Pathological N2 upstaging was higher in open surgery (9.7%) compared to VATS (5.6%) and RATS (5.6%). However, the recur- rence rate in VATS was significantly higher than in RATS (log rank p = 0.03). No statistically significant differences were detected in 5-year OS and cancer-specific survival. Conclusions: no differences were found in OS and cancer-specific survival between VATS, RATS and open lobectomy for stage I NSCLC patients; even if in VATS, the incidence of recurrences, in particular local recurrences, was higher than in RATS and in open surgery.

Long-Term Outcomes of Robotic-Assisted, Video-Assisted and Open Surgery in Non-Small Cell Lung Cancer: A Matched Analysis / M. Casiraghi, A. Vincenzo Mariolo, S. Mohamed, G. Sedda, P. Maisonneuve, A. Mazzella, G. Lo Iacono, F. Petrella, L. Spaggiari. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 11:12(2022), pp. 3363.1-3363.12. [10.3390/jcm11123363]

Long-Term Outcomes of Robotic-Assisted, Video-Assisted and Open Surgery in Non-Small Cell Lung Cancer: A Matched Analysis

M. Casiraghi
Primo
;
F. Petrella
Penultimo
;
L. Spaggiari
Ultimo
2022

Abstract

Introduction: This study makes a comparison between stage I non-small cell lung cancer (NSCLC) patients subjected to either robotic-assisted thoracic surgery (RATS), video-assisted tho- racic surgery (VATS) or open thoracotomy, with the aim to evaluate differences between these three approaches in terms of oncological outcomes. Method: We reviewed data from 1367 consecutive patients who, between 2011 and 2017, underwent lobectomy for NSCLC with either open surgery, VATS or RATS, and performed a matched case-control study based on patients’ age, gender, clinical stage (IA, IB) and ASA score. Results: 180 patients (n = 72 RATS, n = 36 VATS, n = 72 open) were ana- lyzed. Complication rates were found to be comparable (72.2% open, 86.1% VATS, 81.9% RATS), with similar grades of severity. The median number of resected lymph nodes was higher in open surgery (n = 22) than in VATS (n = 15; p = 0.0001) and in RATS (n = 17; p = 0.004). Pathological N2 upstaging was higher in open surgery (9.7%) compared to VATS (5.6%) and RATS (5.6%). However, the recur- rence rate in VATS was significantly higher than in RATS (log rank p = 0.03). No statistically significant differences were detected in 5-year OS and cancer-specific survival. Conclusions: no differences were found in OS and cancer-specific survival between VATS, RATS and open lobectomy for stage I NSCLC patients; even if in VATS, the incidence of recurrences, in particular local recurrences, was higher than in RATS and in open surgery.
stage I NSCLC; minimally invasive surgery robotic surgery; VATS
Settore MED/21 - Chirurgia Toracica
2022
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/959217
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