Propensity score-matching analysis of hybrid video-assisted thoracoscopic surgery and thoracoscopic lobectomy for clinical stage I lung cancer

Iwata, Hiroji; Shirahashi, Koyo; Yamamoto, Hirotaka; Marui, Tsutomu; Matsumoto, Shinsuke; Mizuno, Yoshimasa; Matsumoto, Miho; Mitta, Shohei; Miyamoto, Yusaku; Komuro, Hiroyasu

doi:10.1093/ejcts/ezv296

Cited by 10 publications

(3 citation statements)

References 17 publications

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“…The hybrid VATS lobectomy uses both direct and video visualization, whereas thoracoscopic VATS lobectomy uses only video visualization. A propensity-matched analysis (11) of these methods showed that the former involves shorter operation times and no differences in bleeding, chest tube duration, or complications, as well as no significant differences in OS or DFS. In another study (12), only surgical time (better with muscle-sparing thoracotomy) and hospitalization time (better with VATS) were different between groups.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic segmentectomy: hybrid approach for clinical stage I non-small cell lung cancer

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Thoracoscopic segmentectomy: hybrid approach for clinical stage I non-small cell lung cancer

et al. 2018

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“…Their method seems to be reasonable with respect to the tumor surgical margin issue. Both hybrid VATS [44] and the muscle-sparing thoracotomy [45] approach have a shorter operative time and similar outcomes compared with thoracoscopic lobectomy.…”

Section: Vats Segmentectomymentioning

confidence: 99%

Therapeutic strategy for small-sized lung cancer

Iwata

2016

Gen Thorac Cardiovasc Surg

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Minimizing the volume of lung resection without diminishing curability has recently become an important issue in primary lung cancer. In this review, we will discuss the current state of the feasibility of sublobar resection and specific issues for a segmentectomy procedure. A previous randomized controlled trial showed that lobectomy must still be considered the standard surgical procedure compared with sublobar resection for T1N0 non-small cell lung cancer with a tumor less than 3 cm in size. Since then, supporting studies for segmentectomy of lung cancer with a tumor less than 2 cm in size were reported. In addition, segmentectomy seems to be feasible for clinical stage I adenocarcinoma less than 2 cm in size, in women younger than 70 years old, with a low tumor 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) standardized uptake value (SUV) from propensity-matching studies. In a meta-analysis of sublobar resection vs. lobectomy, intentionally performed sublobar resection showed equivalent outcomes to lobectomy. In the near future, two ongoing prospective, randomized trials will report results. As specific issues for the surgical procedure of segmentectomy, achieving a sufficient surgical margin is an important issue for preventing loco-regional recurrence. More studies regarding the regional lymph node dissection area for segmentectomy are needed. Sublobar resection has the potential to become the standard procedure for peripheral small-sized lung cancer less than 2 cm. However, more information is needed about the characteristics of this cancer and the surgical procedure, including nodal dissection.

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“…Elderly NSCLC patients treated with thoracic lobectomy have a postoperative mortality rate of 0 to 4.8% and a postoperative complication rate of 20-54% [9,10]. Since the rst videoassisted thoracoscopic (VATS) lobectomy was performed in 1992 [11], the continuous development of minimally invasive surgical techniques and instruments, accumulation of surgical experience, and continuous reports of good long-term survival in surgical patients [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] has prompted the NCCN guidelines to recommend VATS lobectomy as a surgical method for treatment of resectable NSCLC [28].…”

Section: Introductionmentioning

confidence: 99%

Short-and long-term outcomes of video-assisted thoracoscopic lobectomy in elderly patients with non-small-cell lung cancer

Yang

Wang

Ren

et al. 2020

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Objective This study aimed to explore the short-and long-term outcomes of video-assisted thoracoscopic (VATS) lobectomy in older patients with non-small-cell lung cancer (NSCLC). Methods A total of 218 NSCLC patient data between January 2014 and January 2019, which included pathological, clinical, and follow-up surveys on VATS lobectomy, were retrospectively analyzed. Of the 218-patient data analyzed, a total of 77 patients were 70 years of age and older (elderly group), while a total of 141 patients were below 70 years of age (nonelderly group).Results Concerning general preoperative data, the simplified comorbidity score (SCS) and the American Society of Anesthesiologists (ASA) scores were higher in the elderly patient group as compared to the nonelderly patient group. Also, elderly patients had poor pulmonary function performance as compared to their counterparts. There were, however, no significant statistical differences found with surgical data between the two groups concerning intraoperative blood loss, operation duration, and conversion to thoracotomy. None of the patients in either of the groups died within thirty days of the operation. Additionally, there were no significant statistical differences in the five-year overall survival rate and the five-year disease-free survival rate between both groups.Conclusion NSCLC treatment with VATS lobectomy is safe and feasible in elderly patients, and it can provide excellent long-term outcomes. However, it is necessary to strengthen perioperative management and promote early postoperative recovery to reduce complications.

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Propensity score-matching analysis of hybrid video-assisted thoracoscopic surgery and thoracoscopic lobectomy for clinical stage I lung cancer

Abstract: In this single-institution, propensity score-matched study, hybrid VATS showed a shorter operative time and similar outcomes compared with thoracoscopic lobectomy for clinical stage IA lung cancer.

Cited by 10 publications

References 17 publications

Thoracoscopic segmentectomy: hybrid approach for clinical stage I non-small cell lung cancer

Thoracoscopic segmentectomy: hybrid approach for clinical stage I non-small cell lung cancer

Therapeutic strategy for small-sized lung cancer

Short-and long-term outcomes of video-assisted thoracoscopic lobectomy in elderly patients with non-small-cell lung cancer

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