Video-assisted thoracoscopic lobectomy versus open lobectomy in the treatment of large lung cancer: propensity-score matched analysis.
Video-assisted thoracoscopic lobectomy versus open lobectomy in the treatment of large lung cancer: propensity-score matched analysis.
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DOI：
10.1186/s13019-021-01749-8
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发表时间：
2022-01-08
影响因子：
1.6
通讯作者：
Cho JH
中科院分区：
文献类型：
--
作者：
Yun J;Lee J;Shin S;Kim HK;Choi YS;Kim J;Zo JI;Shim YM;Cho JH
由于肿瘤细胞溢出的风险增加，对大型肿瘤的胸腔镜手术存在一些担忧。本研究旨在比较视频辅助胸腔镜手术 (VATS) 和开放性肺叶切除术治疗肿瘤大小≥5 cm 的非小细胞肺癌 (NSCLC) 的围手术期结果和肿瘤学有效性。我们回顾性分析了 2009 年 1 月至 2016 年 12 月期间接受肺叶切除术的 355 例实体瘤成分直径≥5 cm 的临床 N0 NSCLC 患者。排除肿瘤侵犯邻近结构的患者。将患者分为VATS组（n = 132）和开胸手术组（n = 223）。应用倾向评分匹配（1:1）。经过倾向评分匹配后，匹配了204名患者，两组临床特征均衡良好。与开胸手术组相比，VATS 组的住院时间较短（6 天与 7 天；P<0.001）。两组的5年总生存率（VATS组71.5% vs开胸组64.4%，P = 0.390）和5年无复发生存率（VATS组60.1% vs开胸组51.5%，P = 0.210）差异无统计学意义。两组间同侧胸膜复发的累积发生率无显着差异（VATS 为 12.0%，开胸手术为 7.9%；P = 0.582）。在大于 5 厘米的临床 N0 NSCLC 中，与开腹肺叶切除术相比，VATS 肺叶切除术可缩短住院时间并实现相似的生存结果。根据这些结果，VATS 肺叶切除术对于这部分患者来说是一个有价值的选择。在线版本包含可在 10.1186/s13019-021-01749-8 获取的补充材料。
There are several concerns on thoracoscopic surgery for large tumors because of the increased risk of tumor cell spillage. This study aimed to compare perioperative outcomes and oncological validity between video-assisted thoracoscopic surgery (VATS) and open lobectomy for non-small cell lung cancer (NSCLC) with tumor size > 5 cm. We retrospectively reviewed 355 patients who underwent lobectomy with clinical N0 NSCLC with solid tumor component diameter > 5 cm between January 2009 and December 2016. Patients with tumor invading adjacent structures were excluded. The patients were divided into the VATS group (n = 132) and thoracotomy group (n = 223). Propensity score matching (1:1) was applied. After propensity score matching, 204 patients were matched, and clinical characteristics of the two groups were well balanced. The VATS group was associated with a shorter length of hospital stay (6 days vs. 7 days; P < 0.001) than the thoracotomy group. There were no significant differences in the 5-year overall survival (71.5% in VATS vs. 64.4% in thoracotomy, P = 0.390) and 5-year recurrence-free survival (60.1% in VATS vs. 51.5% in thoracotomy, P = 0.210) between the two groups. The cumulative incidence of ipsilateral pleural recurrence was not significantly different between the two groups (12.0% in VATS vs. 7.9% in thoracotomy; P = 0.582). In clinical N0 NSCLC larger than 5 cm, VATS lobectomy resulted in shorter hospital stay and similar survival outcome compared to open lobectomy. Based on these results, VATS lobectomy is a valuable option in this subset of patients. The online version contains supplementary material available at 10.1186/s13019-021-01749-8.
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影响因子：
3.8
作者：
Watanabe, A;Koyanagi, T;Abe, T
通讯作者：
Abe, T
影响因子：
4.6
作者：
Kim, Kwhanmien;Kim, Hong Kwan;Shim, Young Mog
通讯作者：
Shim, Young Mog
影响因子：
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Goldstraw, Peter;Chansky, Kari;Bolejack, Vanessa
通讯作者：
Bolejack, Vanessa
影响因子：
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作者：
Whitson, Bryan A.;Groth, Shawn S.;Maddaus, Michael A.
通讯作者：
Maddaus, Michael A.
影响因子：
4.6
作者：
Cho, Sukki;Song, In Hag;Jheon, Sanghoon
通讯作者：
Jheon, Sanghoon