Radicality of lymphadenectomy in lung cancer resections by thoracotomy and video-assisted thoracoscopic approach: a prospective, multicentre and propensity-score adjusted study

Lung Cancer ◽  
2022 ◽  
Author(s):  
Carme Obiols ◽  
Sergi Call ◽  
Ramón Rami-Porta ◽  
Ángeles Jaén ◽  
David Gómez de Antonio ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Thoracoscopic Approach ◽  
Video Assisted

scholarly journals Propensity-score adjusted comparison of pathologic nodal upstaging by robotic, video-assisted thoracoscopic, and open lobectomy for non–small cell lung cancer

2019 ◽  
Vol 158 (5) ◽  
pp. 1457-1466.e2 ◽  
Author(s):  
Peter J. Kneuertz ◽  
Danjouma H. Cheufou ◽  
Desmond M. D'Souza ◽  
Khaled Mardanzai ◽  
Mahmoud Abdel-Rasoul ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Video Assisted ◽  
Nodal Upstaging ◽  
Open Lobectomy

scholarly journals Video-assisted thoracoscopic lobectomy versus open lobectomy in the treatment of large lung cancer: propensity-score matched analysis

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Jeonghee Yun ◽  
Junghee Lee ◽  
Sumin Shin ◽  
Hong Kwan Kim ◽  
Yong Soo Choi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Hospital Stay ◽  
Propensity Score Matching ◽  
Thoracoscopic Surgery ◽  
Perioperative Outcomes ◽  
Vats Lobectomy ◽  
Video Assisted ◽  
Increased Risk ◽  
Open Lobectomy

Abstract Background There are several concerns on thoracoscopic surgery for large tumors because of the increased risk of tumor cell spillage. This study aimed to compare perioperative outcomes and oncological validity between video-assisted thoracoscopic surgery (VATS) and open lobectomy for non-small cell lung cancer (NSCLC) with tumor size > 5 cm. Methods We retrospectively reviewed 355 patients who underwent lobectomy with clinical N0 NSCLC with solid tumor component diameter > 5 cm between January 2009 and December 2016. Patients with tumor invading adjacent structures were excluded. The patients were divided into the VATS group (n = 132) and thoracotomy group (n = 223). Propensity score matching (1:1) was applied. Results After propensity score matching, 204 patients were matched, and clinical characteristics of the two groups were well balanced. The VATS group was associated with a shorter length of hospital stay (6 days vs. 7 days; P < 0.001) than the thoracotomy group. There were no significant differences in the 5-year overall survival (71.5% in VATS vs. 64.4% in thoracotomy, P = 0.390) and 5-year recurrence-free survival (60.1% in VATS vs. 51.5% in thoracotomy, P = 0.210) between the two groups. The cumulative incidence of ipsilateral pleural recurrence was not significantly different between the two groups (12.0% in VATS vs. 7.9% in thoracotomy; P = 0.582). Conclusions In clinical N0 NSCLC larger than 5 cm, VATS lobectomy resulted in shorter hospital stay and similar survival outcome compared to open lobectomy. Based on these results, VATS lobectomy is a valuable option in this subset of patients.

scholarly journals Cost and survival of video-assisted thoracoscopic lobectomy versus open lobectomy in lung cancer patients: a propensity score-matched study

2019 ◽  
Vol 57 (1) ◽  
pp. 92-99 ◽  
Author(s):  
Pavo Marijic ◽  
Julia Walter ◽  
Christian Schneider ◽  
Larissa Schwarzkopf
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Hospital Stay ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Economic Benefits ◽  
Wilcoxon Test ◽  
Lung Cancer Patients ◽  
Video Assisted ◽  
Patient Reported

Abstract OBJECTIVES A video-assisted thoracoscopic surgery (VATS) is an accepted alternative to open thoracotomy (OT) in lung cancer patients undergoing lobectomy, but evidence of the benefits of VATS remains inconsistent. The aim of this study was to compare VATS and OT regarding survival, costs and length of hospital stay (LOS). METHODS We identified lung cancer patients (incident 2013) undergoing VATS or OT from German insurance claims data and performed 1:2 propensity score matching. A 3-year survival was analysed using the Kaplan–Meier curves and a univariable Cox model. Group differences in the 3-year lung cancer-related costs and costs of hospital stay with lobectomy were compared via univariable generalized linear gamma models. LOS was compared using the Mann–Whitney–Wilcoxon test. RESULTS After propensity score matching, we compared 294 patients undergoing VATS and 588 receiving OT. We found no differences in the 3-year survival (VATS: 73.8%, OT: 69.2%, P = 0.131) or costs for hospital stay with lobectomy (VATS: €11 921, OT: €12 281, P = 0.573). However, VATS patients had significantly lower lung cancer-related costs (VATS: €20 828, OT: €23 723, P = 0.028) and median postoperative LOS (VATS: 9 days, OT: 11 days, P &lt; 0.001). CONCLUSIONS From a payer's perspective, extending the use of VATS is beneficial, as it shows economic benefits without affecting survival. However, for a more comprehensive assessment of the benefits of VATS from a society’s point of view, further aspects such as patient-reported outcomes and provider-related standby costs need to be investigated further.

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