Long-Term Outcomes of Robotic-Assisted, Video-Assisted and Open Surgery in Non-Small Cell Lung Cancer: A Matched Analysis

Overview

Journal J Clin Med

Specialty General Medicine

Date 2022 Jun 24

PMID 35743434

Authors

Monica Casiraghi

Alessio Vincenzo Mariolo

Shehab Mohamed

Giulia Sedda

Patrick Maisonneuve

Antonio Mazzella

Giorgio Lo Iacono

Francesco Petrella

Lorenzo Spaggiari

Affiliations

Soon will be listed here.

Abstract

Introduction: This study makes a comparison between stage I non-small cell lung cancer (NSCLC) patients subjected to either robotic-assisted thoracic surgery (RATS), video-assisted thoracic surgery (VATS) or open thoracotomy, with the aim to evaluate differences between these three approaches in terms of oncological outcomes.

Method: We reviewed data from 1367 consecutive patients who, between 2011 and 2017, underwent lobectomy for NSCLC with either open surgery, VATS or RATS, and performed a matched case-control study based on patients' age, gender, clinical stage (IA, IB) and ASA score.

Results: 180 patients (n = 72 RATS, n = 36 VATS, n = 72 open) were analyzed. Complication rates were found to be comparable (72.2% open, 86.1% VATS, 81.9% RATS), with similar grades of severity. The median number of resected lymph nodes was higher in open surgery (n = 22) than in VATS (n = 15; = 0.0001) and in RATS (n = 17; = 0.004). Pathological N2 upstaging was higher in open surgery (9.7%) compared to VATS (5.6%) and RATS (5.6%). However, the recurrence rate in VATS was significantly higher than in RATS (log rank = 0.03). No statistically significant differences were detected in 5-year OS and cancer-specific survival.

Conclusions: no differences were found in OS and cancer-specific survival between VATS, RATS and open lobectomy for stage I NSCLC patients; even if in VATS, the incidence of recurrences, in particular local recurrences, was higher than in RATS and in open surgery.

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