A Brief Report on Survival After Robotic Lobectomy for Early-Stage Lung Cancer

Spaggiari, Lorenzo; Maisonneuve, Patrick; Tessitore, Adele; Casiraghi, Monica; Petrella, Francesco; Galetta, Domenico

doi:10.1016/j.jtho.2019.07.032

Cited by 22 publications

(21 citation statements)

References 4 publications

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“…Although this may simply be due to a sampling effect, we could argue that single-station-N2 disease may represent a more favorable subgroup of patients, as reported in recent literature [21][22][23][24][25]. Finally, no difference was observed between open and minimally invasive approaches, thus confirming the now well-known concept that the minimally invasive approach is at least not inferior to open surgery in terms of oncological results; in any case, we adopted a minimally invasive approach frequently for patients with an early-stage disease and only in a few cases for carefully selected N2 patients [26,27].…”

Section: Discussionsupporting

confidence: 80%

Prognostic Value of the Hemoglobin/Red Cell Distribution Width Ratio in Resected Lung Adenocarcinoma

Petrella

Casiraghi

Radice

et al. 2021

Cancers

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Background: The ratio of hemoglobin to red cell distribution width (HRR) has been described as an effective prognostic factor in several types of cancer. The aim of this study was to investigate the prognostic role of preoperative HRR in resected-lung-adenocarcinoma patients. Methods: We enrolled 342 consecutive patients. Age, sex, surgical resection, adjuvant treatments, pathological stage, preoperative hemoglobin, red cell distribution width, and their ratio were recorded for each patient. Results: Mean age was 66 years (SD: 9.0). There were 163 females (47.1%); 169 patients (49.4%) had tumors at stage I, 71 (20.8%) at stage II, and 102 (29.8%) at stage III. In total, 318 patients (93.0%) underwent lobectomy, and 24 (7.0%) pneumonectomy. Disease-free survival multivariable analysis disclosed an increased hazard ratio (HR) of relapse for preoperative HRR lower than 1.01 (HR = 2.20, 95%CI: (1.30–3.72), p = 0.004), as well as for N1 single-node (HR = 2.55, 95%CI: (1.33–4.90), p = 0.005) and multiple-level lymph node involvement compared to N0 for both N1 (HR = 9.16, 95%CI:(3.65–23.0), p < 0.001) and N2 (HR = 10.5, 95%CI:(3.44–32.2, p < 0.001). Conclusion: Pre-operative HRR is an effective prognostic factor of disease-free survival in resected-lung-adenocarcinoma patients, together with the level of pathologic node involvement.

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Section: Discussionsupporting

confidence: 80%

Prognostic Value of the Hemoglobin/Red Cell Distribution Width Ratio in Resected Lung Adenocarcinoma

Petrella

Casiraghi

Radice

et al. 2021

Cancers

Self Cite

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“…Other series also describe similar R0 resection rates of 97% [38]. Five-year disease recurrence has reported to be from 3% to 24.9% depending on cancer stage, which is also comparable to open surgery for appropriately matched patients [32,39]. In this series and others, overall and disease-free survival at three and five years did not differ between RATS and either open surgery or VATS [32,37,38,[40][41][42][43].…”

Section: Patient Outcomessupporting

confidence: 74%

Robotic Surgery for Non-Small Cell Lung Cancer

Li¹,

Blasberg²

2021

Lung Cancer - Modern Multidisciplinary Management

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Pulmonary resection has been a cornerstone in the management of patients with non-small cell lung cancer (NSCLC) for decades. In recent years, the popularity of minimally-invasive techniques as the primary method to manage NSCLC has grown significantly. With smaller incisions and a lower incidence of peri-operative complications, minimally-invasive lung resection, accomplished through keyhole incisions with miniaturized cameras and similarly small instruments that work through surgical ports, has been shown to retain equivalent oncologic outcomes to the traditional gold standard open thoracotomy. This technique allows for the safe performance of anatomic lung resection with complete lymphadenectomy and has been a part of thoracic surgery practice for three decades. Robotic-assisted thoracoscopic surgery (RATS) represents another major advancement for lung resection, broadening the opportunity for patients to undergo minimally invasive surgery for NSCLC, and therefore allowing a greater percentage of the lung cancer population to benefit from many of the advantages previously demonstrated from video assisted thoracoscopic surgery (VATS) techniques. RATS surgery is also associated with several technical advantages to the surgeon. For a surgeon who performs open procedures and is looking to adopt a minimally invasive approach, RATS ergonomics are a natural transition compared to VATS, particularly given the multiple degrees of freedom associated with robotic articulating instruments. As a result, this platform has been adopted as a primary approach in numerous institutions across the United States. In this chapter, we will explore the advantages and disadvantages of robotic-assisted surgery for NSCLC and discuss the implications for increased adoption of minimally invasive surgery in the future of lung cancer treatment.

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“…Retrospective reviews of robotic approaches for rectal cancer, lung cancer, and endometrial cancer all show similar survival and recurrence rates when compared with the traditional open or laparoscopic approach. 16,[20][21][22][23] In addition, Hussein and colleagues analyzed major oncologic endpoints at 10 years from a total of 446 patients who underwent robotic-assisted robotic cystectomy. 24 Recurrence-free survival, disease-specific survival, and overall survival were similar to those reported historically for open cystectomy.…”

Section: Discussionmentioning

confidence: 99%

Learning Curve for Robotic-Assisted Laparoscopic Retroperitoneal Lymph Node Dissection

Schermerhorn

Christman

Rocco

et al. 2021

Journal of Endourology

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Introduction: Robotic retroperitoneal lymph node dissection (R-RPLND) is a challenging procedure. We hypothesized that surgical times and operative complications would decrease as surgeons became more facile with R-RPLND. Materials and Methods: We retrospectively reviewed 121 consecutive R-RPLNDs performed at Naval Medical Center San Diego and Mayo Clinic Arizona by 4 fellowship trained robotic surgeons between 2008 and 2018. Linear regression was used to analyze independent predictors of setup time, operative time, and lymph node counts. Logistic regression was used to analyze open conversions, overall complications, and high-grade complications. Variables included as independent predictors were: sequential case number, surgeon, clinical stage, chemotherapy status, RPLND template, and body mass index. Univariate and multivariate analyses were conducted. Statistical significance was established at a = 0.05. Results: There was no change in setup time with case number ( p = 0.317), but differences were noted between surgeons. Operative times decreased with increasing case number ( p < 0.001) but were negatively affected by clinical stage III testis cancer ( p = 0.029) and history of chemotherapy exposure ( p = 0.050). Surgical times are predicted to decrease by 1 hour after 44 cases. Lymph node counts were dependent only on the surgeon. No factors were predictive of open conversions. Fewer overall complications occurred as experience was gained ( p = 0.001), but high-grade complications could not be predicted. Conclusions: Consistent with the learning curves shown for other technologically advanced surgical techniques, experience appears to improve surgical times and lower complication rates for R-RPLND.

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A Brief Report on Survival After Robotic Lobectomy for Early-Stage Lung Cancer

Cited by 22 publications

References 4 publications

Prognostic Value of the Hemoglobin/Red Cell Distribution Width Ratio in Resected Lung Adenocarcinoma

Prognostic Value of the Hemoglobin/Red Cell Distribution Width Ratio in Resected Lung Adenocarcinoma

Robotic Surgery for Non-Small Cell Lung Cancer

Learning Curve for Robotic-Assisted Laparoscopic Retroperitoneal Lymph Node Dissection

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