Thoracoscopic Lobectomy Facilitates the Delivery of Chemotherapy after Resection for Lung Cancer

Petersen, Rebecca P.; Pham, Duy Khanh; Burfeind, William R.; Hanish, Steven I.; Toloza, Eric M.; Harpole, David H.; D’Amico, Thomas A.

doi:10.1016/j.athoracsur.2006.12.029

Cited by 269 publications

(152 citation statements)

References 25 publications

Supporting

Mentioning

137

Contrasting

Unclassified

Order By: Relevance

“…Recent analysis of post-operative outcomes performed on both single institutional series and official databases proposed VATS-L to be superior in terms of length of stay, post-operative pain, preserving pulmonary function, postoperative complications and compliance with adjuvant chemotherapy when compared to open lobectomy (1)(2)(3)(4)(5)(6). Moreover, VATS-L has been recommended by National Comprehensive Cancer Network (NCCN) guidelines as the preferred approach for early-stage NSCLC (15).…”

Section: Resultsmentioning

confidence: 99%

“…Video-assisted thoracoscopic lobectomy (VATS-L) is a well-established approach for early-stage non-small cell lung cancer (NSCLC) (1)(2)(3) and is associated with a shorter length of stay, less post-operative pain, preserved pulmonary function, fewer post-operative complications and better compliance with adjuvant chemotherapy than lobectomy via thoracotomy (4)(5)(6). Furthermore, several and authoritative authors demonstrated the efficacy of VATS lobectomy in terms of oncological results and validity of mediastinal intra-operative staging (7)(8)(9)(10), but the use of VATS-L for locally advanced-stage NSCLC is not well established.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

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

View full text Add to dashboard Cite

show abstract

“…Initial skeptism and concerns about VATS safety, oncological clearance, long-term benefits, and cost-effectiveness are unfounded [2,3]. On the other hand, the benefits associated with VATS major lung resection including less blood loss and transfusion requirements, less postoperative pain, better preserved pulmonary and shoulder function, shorter chest drain duration and hospital stay, as well as better patient tolerance and compliance to subsequent adjuvant chemotherapy, compared with the thoracotomy approach are increasingly being appreciated [3][4][5][6][7]. Moreover, improved intermediate to longterm survival in favor of VATS for early non-small cell lung cancer when compared to the open technique have been shown in nonrandomized studies [2,3,8,9].…”

Section: Introductionmentioning

confidence: 99%

Surgical Trauma and Immune Functional Changes Following Major Lung Resection

Lau

2013

Indian J Surg

View full text Add to dashboard Cite

Video-assisted thoracic surgery (VATS) has evolved greatly over the last two decades. VATS major lung resection for early stage non-small cell lung carcinoma (NSCLC) has been shown to result in less postoperative pain, less pulmonary dysfunction postoperatively, shorter hospital stay, and better patient tolerance to adjuvant chemotherapy compared with patients who underwent thoracotomy. Several recent studies have even reported improved long-term survival in those who underwent VATS major lung resection for early stage NSCLC when compared with open technique. Interestingly, the immune status and autologous tumor killing ability of lung cancer patients have previously been associated with long-term survival. VATS major lung resection can result in an attenuated postoperative inflammatory response. Furthermore, the minimal invasive approach better preserve patients' postoperative immune function, leading to higher circulating natural killer and T cells numbers, T cell oxidative activity, and levels of immunochemokines such as insulin growth factor binding protein 3 following VATS compared with thoracotomy. Apart from host immunity, the angiogenic environment following surgery may also have a role in determining cancer recurrence and possibly survival. Whether differences in immunological and biochemical mediators contribute significantly towards improved clinical outcomes following VATS major lung resection for lung cancer remains to be further investigated. Future studies will also need to address whether the reduced access trauma from advanced thoracic surgical techniques, such as single-port VATS, can further attenuate the postoperative inflammatory response.

show abstract

“…This approach is attractive in the older population or in patients with limited pulmonary function [68,69]. In addition, patients undergoing VATS resections appear to have fewer delays in receiving adjuvant chemotherapy and to require fewer dose reductions during adjuvant chemotherapy [70].…”

Section: Surgery For Early Stage Lung Cancer (Stage I and Ii)mentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

European Respiratory Review

View full text Add to dashboard Cite

Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

show abstract

Thoracoscopic Lobectomy Facilitates the Delivery of Chemotherapy after Resection for Lung Cancer

Cited by 269 publications

References 25 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

Surgical Trauma and Immune Functional Changes Following Major Lung Resection

Surgery for nonsmall cell lung cancer

Contact Info

Product

Resources

About