Current data suggests that robot-assisted NF procedures have similar patient outcomes to conventional laparoscopic NF, with the exception of added cost and higher re-admission rate. While the higher costs are expected given the new technology, increasing re-admission rates are concerning and may represent the level of experience of the surgeon as well as the robotic learning curve.
We performed a retrospective study comparing volumetric and unidimensional tumor size measurements in patients with advanced nonesmall-cell lung cancer. Cox regression analysis of the 77 patients analyzed demonstrated that only change in tumor volume and the initial tumor size predicted survival, indicating that volume is a better marker of survival compared with the diameter measurements that underlie Response Evaluation Criteria In Solid Tumors (RECIST). Introduction: We evaluated volumetric tumor measurements and computed tomography texture analysis as prognostic indicators in patients with advanced nonesmall-cell lung cancer when compared with the unidimensional tumor size measurements used in Response Evaluation Criteria in Solid Tumors (RECIST). Patients and Methods: In a retrospective review, computed tomography examinations in 77 patients with advanced nonesmall-cell lung cancer were evaluated before and after 2 cycles of chemotherapy. Baseline and changes in tumor diameter, volume, and texture were analyzed. Survival was analyzed with Cox regression analysis and Kaplan-Meier survival statistics. Results: Cox regression analysis demonstrated that only change in tumor volume (exp(B) ¼ 1.006; P ¼ .02) and the initial sum of the largest target lesion diameters predicted survival (exp(B) ¼ 1.013; P ¼ .02). Kaplan-Meier statistics demonstrated that patients with an initial sum of the largest target lesion diameters less than 88 mm had median survival time of 587 days (95% confidence interval [CI], 269-905 days), compared with the survival of those with larger tumor burden of 407 days (95% CI, 235-579 days). Patients in whom tumor volume decreased by more than 29% had a median survival time of 622 days (95% CI, 448-796 days), compared with 305 days for those with less decrease (95% CI, 34-240 days). Conclusion: This study demonstrates that change in lung tumor volume is a better marker of patient survival than change of unidimensional diameter measurements in our cohort. If confirmed in larger studies, this suggests that volumetry might improve clinical decision-making for individual patients and allow for faster assessment of new treatments.
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