Postoperative outcomes, lymph node dissection and effects on costs among thoracotomy, video-assisted and robotic-assisted lobectomy for clinical stage I non-small cell lung cancer

Gullo, Roberto Lo; Gagliardo, Carola Maria; Palazzolo, M; Porrello, Calogero; Gulotta, Leonardo; Faso, Felice Lo; Gulotta, Gaspare

doi:10.23736/s2724-5691.20.08395-9

Cited by 6 publications

(4 citation statements)

References 30 publications

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“…However, the higher nodal dissection rates were not associated with cancer upstaging, 23 RVlob also reported significantly higher hospitalization costs in the RTS group 23 . This is in concordance with multiple previous reports from clinical studies and meta-analyses 24–27 . RVlob also reported postoperative pain using a visual analog or numeric rating score, and health-related quality of life (HRQOL) using the EQ-5D following RTS-lobectomy and VATS-lobectomy at weeks 4, 24, and 48 28 .…”

Section: Discussionsupporting

confidence: 86%

“…23 This is in concordance with multiple previous reports from clinical studies and metaanalyses. [24][25][26][27] RVlob also reported postoperative pain using a visual analog or numeric rating score, and health-related quality of life (HRQOL) using the EQ-5D following RTS-lobectomy and VATS-lobectomy at weeks 4, 24, and 48. 28 They found that the mean pain score of patients after RTS was significantly lower at week 4 and that the HRQOL scores were comparable between the 2 groups during the entire study period.…”

Section: Discussionmentioning

confidence: 99%

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Robotic Lobectomy is Cost-Effective and Provides Comparable Health Utility Scores to Video-Assisted Lobectomy

et al. 2023

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Objective: Determine if robotic-assisted lobectomy (RPL-4) is cost-effective and offers improved patient-reported health utility for patients with early-stage NSCLC when compared to video-assisted lobectomy (VATS-Lobectomy). Summary Background Data: Barriers against the adoption of RPL-4 in publicly-funded healthcare include the paucity of high-quality prospective trials and the perceived high cost of robotic surgery. Methods: Patients were enrolled in a blinded, multi-centered, RCT in Canada, the USA, and France, and were randomized 1:1 to either RPL-4 or VATS-Lobectomy. EQ-5D-5L was administered at baseline and post-operative day 1; weeks 3, 7, 12; and months 6 and 12. Direct and indirect costs were tracked using standard methods. Seemingly Unrelated Regression was applied to estimate the cost effect, adjusting for baseline health utility. Incremental cost effectiveness ratio was generated by 10,000 bootstrap samples with multivariate imputation by chained equations. Results: Of 406 patients screened, 186 were randomized, and 164 analyzed after final eligibility review (RPL-4:n=81; VATS-Lobectomy:n=83). Twelve-month follow-up was completed by 94.51%(155/164) of participants. Median age was 68(60-74). There were no significant differences in body mass index, comorbidity, pulmonary function, smoking status, baseline health utility, or tumor characteristics between arms. The mean 12-week health utility score was 0.85(0.10) for RPL-4 and 0.80(0.19) for VATS-Lobectomy (P=0.02). Significantly more lymph nodes were sampled [10(8-13) vs 8(5-10); P=0.003] in the RPL-4 arm. The incremental cost/QALY of RPL-4 was $14,925.62(95% CI $6,843.69,$23,007.56) at 12-months. Conclusions: Early results of the RAVAL trial suggest that RPL-4 is cost-effective and associated with comparable short-term patient-reported health utility scores when compared to VATS-Lobectomy.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Robotic Lobectomy is Cost-Effective and Provides Comparable Health Utility Scores to Video-Assisted Lobectomy

et al. 2023

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“…[1][2][3] Non-small cell lung cancer (NSCLC) is the major type, and lobectomy is one the effective treatments for early NSCLC. [4] Nowadays, the rapidly emerging technique, video-assisted thoracoscopic lobectomy (VATL) is the prior recommended treatment for NSCLC, with the advantages of small trauma, less postoperative pain, quick recovery, and better patient satisfaction. [5][6][7][8] Recently, VATL continues to improve with the decreasing working port size and incisions.…”

Section: Introductionmentioning

confidence: 99%

“…Lung cancer is one of the most common malignant tumors, with the highest morbidity and mortality rate worldwide, which seriously threatens human health and life [1–3] . Non-small cell lung cancer (NSCLC) is the major type, and lobectomy is one the effective treatments for early NSCLC [4] . Nowadays, the rapidly emerging technique, video-assisted thoracoscopic lobectomy (VATL) is the prior recommended treatment for NSCLC, with the advantages of small trauma, less postoperative pain, quick recovery, and better patient satisfaction [5–8] .…”

Section: Introductionmentioning

confidence: 99%

Acupuncture against chronic postsurgical pain in non-small cell lung cancer patients

Li¹,

Zhang²,

Wang³

et al. 2021

Medicine

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Introduction: Video-assisted thoracoscopic lobectomy is the prior recommended treatment for non-small cell lung cancer (NSCLC), with the advantages of small trauma, less postoperative pain, and quick recovery. However, a large number of patients may suffer chronic postsurgical pain (CPSP), which makes the patients unwilling to practice pulmonary exercises, and it would directly affect patient's cough, sputum expectoration, and mobility. Opioids could greatly improve the quality of postoperative analgesia and the quality of life after surgery, but it is accompanied with obvious side effects. A number of clinical studies have proved that acupuncture could improve postoperative pain and reduce opioid use. In this study, we try to conduct a randomized controlled study to evaluate the efficacy and safety of plum-blossom needle acupuncture combined with Tramadol in improving CPSP after lobectomy in NSCLC patients. Methods: Patients will be randomly divided into treatment group (acupuncture plus Tramadol) and control group (sham acupuncture plus Tramadol) with a random number table in 1:1 ratio. The patients, outcome assessor, and statistician will be blinded. The outcomes are changes of numerical rating scale, Karnofsky performance score, brief pain inventory, blood routine, liver and kidney function. The data will be analyzed by SPSS 22.0. Conclusions: The results will help to evaluate the efficacy and safety of plum-blossom needle acupuncture in improving CPSP after lobectomy in NSCLC patients.

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Tracheal fistula repair with stent placement after failure of reconstruction with muscle tissue. A lung cancer surgery complication

Τryfon

Saroglou

Matthaios³

et al. 2021

Respiratory Medicine Case Reports

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Postoperative outcomes, lymph node dissection and effects on costs among thoracotomy, video-assisted and robotic-assisted lobectomy for clinical stage I non-small cell lung cancer

Cited by 6 publications

References 30 publications

Robotic Lobectomy is Cost-Effective and Provides Comparable Health Utility Scores to Video-Assisted Lobectomy

Robotic Lobectomy is Cost-Effective and Provides Comparable Health Utility Scores to Video-Assisted Lobectomy

Acupuncture against chronic postsurgical pain in non-small cell lung cancer patients

Tracheal fistula repair with stent placement after failure of reconstruction with muscle tissue. A lung cancer surgery complication

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