Thoracoscopic Anatomic Pulmonary Resection for Locally Advanced Non-Small Cell Lung Cancer

Nakanishi, Ryoichi; Fujino, Yoshihisa; Yamashita, Toshihiro; Shinohara, Shinji; Oyama, Tsunehiro

doi:10.1016/j.athoracsur.2013.10.082

Cited by 34 publications

(30 citation statements)

References 24 publications

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“…Other similar works about VATS-L versus open lobectomy (12,(16)(17)(18) showed different complication rates ranging from 25% to 40%, but statistically not higher compared to the open approach. Gonzalez-Rivas et al, comparing early stage (cT1 and cT2) and advanced stage NSCLC treated by uniportal VATS-L, obtained a complication rate of 17.2% and 14.0%, respectively (13).…”

Section: Resultsmentioning

confidence: 99%

Thoracoscopic lobectomy for locally advanced-stage non-small cell lung cancer is a feasible and safe approach: analysis from multi-institutional national database

et al. 2017

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Background: Video-assisted thoracoscopic lobectomy (VATS-L) is a well-established approach for earlystage non-small cell lung cancer (NSCLC) with functional and oncological outcomes similar to thoracotomy.The role of VATS-L in locally advanced stage of NSCLC has not been well standardized. The objective of this study was to evaluate the state of the art in Italy of VATS-L for NSCLC advanced stages using the data from the Italian VATS Group Database. (A) early stages and (B) locally-advanced stages (tumours with dimension >5 cm (cT2b), cT3, cT4 and/or tumours that received neo-adjuvant chemotherapy). A retrospective study was performed, to evaluate the safety and the oncological adequacy of VATS-L comparing peri-operative outcomes and pathological data.Results: A total of 3,266 (87.7%) patients were included into the group A, while 454 (13.3%) patients formed the group B. VATS-L for locally advanced-stage NSCLC is associated with a longer procedure, a higher estimated blood loss, an increased incidence of conversion (9.3% vs. 13.0%, P=0.018) and a significant higher number of total, hilar and mediastinal dissected lymph nodes. The mortality rate (1.6% vs. 1.5%), the proportion of patients who suffered any complication (24.8% vs. 29.1%) and the hospitalization were not statistically different between the two groups (P=0.880, 0.057 and 0.660, respectively); the overall complication rate was statistically higher in group B (30.4% vs. 37.0%; P=0.04). Patients of group B who required conversion had a statistically significantly higher operative time (P<0.01), blood loss (P<0.01) and hospital stay (P<0.01), but not significantly higher overall morbidity rate (35.5% vs. 28.0%) compared with patients completely operated by VATS.Conclusions: VATS-L for locally advanced-stage NSCLC in Italy is a safe and effective procedure when performed in appropriately selected patients, ensuring peri-operative results similar to those obtained in early-stage tumours.

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Section: Resultsmentioning

confidence: 99%

Thoracoscopic lobectomy for locally advanced-stage non-small cell lung cancer is a feasible and safe approach: analysis from multi-institutional national database

et al. 2017

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“…Compare to open thoracotomy, VATS lobectomy offers many potential benefits such as decreased postoperative pain, reduced hospital length of stay, diminished inflammatory response, faster access to adjuvant chemotherapy and faster recovery. Despite these advantages, majority of publications on VATS lobectomy are limited to the patients of early stage, it is recently even attempted in advanced lung cancer patients (13,14). However, the role of VATS for treatment of locally advanced NSCLC is still infrequent and has been remain controversial.…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of uniportal video-assisted thoracoscopic surgery for locally advanced non-small cell lung cancer

Fan¹,

Yao²,

Wang³

et al. 2016

J. Thorac. Dis.

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Background: Conventional video-assisted thoracoscopic surgery (VATS) lobectomy for locally advanced non-small cell lung cancer (NSCLC) is a feasible and safe surgery in high-volume centers with significant VATS experience. Uniportal VATS lobectomy has been recently been reported to be a promising, less invasive approach. The purpose of this study is to explore the safety and feasibility of uniportal video-assisted thoracoscopic surgery (U-VATS) for the treatment of patients with locally advanced NSCLC. Conclusions: Uniportal VATS major pulmonary resections and mediastinal lymph node dissection is a safe and feasible procedure for the treatment of locally advanced NSCLC. Particularly it is suitable for the frail patients with locally advanced NSCLC who require comprehensive treatment.

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“…Minimally invasive (robotic assisted thoracic surgery and videoassisted thoracic surgery) lobectomy for the treatment of locally advanced non-small cell lung cancer Recently a limited number of case series have been published on the feasibility of the VATS approach for locally advanced NSCLC (17)(18)(19)(20). The main focus of these studies was the feasibility of a minimally invasive approach in carefully selected patients.…”

Section: Original Articlementioning

confidence: 99%

Minimally invasive (robotic assisted thoracic surgery and video-assisted thoracic surgery) lobectomy for the treatment of locally advanced non-small cell lung cancer

et al. 2016

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Background: Insufficient data exist on the results of minimally invasive surgery (MIS) for locally advanced non-small cell lung cancer (NSCLC) traditionally approached by thoracotomy. The use of telerobotic surgical systems may allow for greater utilization of MIS approaches to locally advanced disease. We will review the existing literature on MIS for locally advanced disease and briefly report on the results of a recent study conducted at our institution. Methods: We performed a retrospective review of a prospective single institution database to identify patients with clinical stage II and IIIA NSCLC who underwent lobectomy following induction chemotherapy. The patients were classified into two groups (MIS and thoracotomy) and were compared for differences in outcomes and survival. Results: From January 2002 to December 2013, 428 patients {397 thoracotomy, 31 MIS [17 robotic and 14 video-assisted thoracic surgery (VATS)]} underwent induction chemotherapy followed by lobectomy. The conversion rate in the MIS group was 26% (8/31) The R0 resection rate was similar between the groups (97% for MIS vs. 94% for thoracotomy; P=0.71), as was postoperative morbidity (32% for MIS vs. 33% for thoracotomy; P=0.99). The median length of hospital stay was shorter in the MIS group (4 vs. 5 days; P<0.001). The 3-year overall survival (OS) was 48.3% in the MIS group and 56.6% in the thoracotomy group (P=0.84); the corresponding 3-year DFS were 49.0% and 42.1% (P=0.19). Conclusions: In appropriately selected patients with NSCLC, MIS approaches to lobectomy following induction therapy are feasible and associated with similar disease-free and OS to those following thoracotomy.

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Thoracoscopic Anatomic Pulmonary Resection for Locally Advanced Non-Small Cell Lung Cancer

Cited by 34 publications

References 24 publications

Thoracoscopic lobectomy for locally advanced-stage non-small cell lung cancer is a feasible and safe approach: analysis from multi-institutional national database

Thoracoscopic lobectomy for locally advanced-stage non-small cell lung cancer is a feasible and safe approach: analysis from multi-institutional national database

Safety and feasibility of uniportal video-assisted thoracoscopic surgery for locally advanced non-small cell lung cancer

Minimally invasive (robotic assisted thoracic surgery and video-assisted thoracic surgery) lobectomy for the treatment of locally advanced non-small cell lung cancer

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