We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Comparison in prognosis after VATS lobectomy and open lobectomy for stage I lung cancer: retrospective analysis focused on a histological subgroup.
- Authors
Sawada, S.; Komori, E.; Yamashita, M.; Nakata, M.; Nishimura, R.; Teramoto, N.; Segawa, Y.; Shinkai, T.
- Abstract
<bold>Background: </bold>Video-assisted thoracoscopic surgery (VATS) has become an attractive surgical procedure, but several issues remain to be resolved. Prognosis after VATS lobectomy is important to evaluate the adequacy of VATS lobectomy as a cancer operation. Interestingly, several investigators, including us, have reported that prognosis after VATS lobectomy was superior to that after open lobectomy in early non-small-cell lung cancer (NSCLC). One of the possible reasons is the low invasiveness of VATS lobectomy. But we considered that patient bias might have some influence favoring VATS lobectomy. To evaluate our hypothesis, we reviewed medical records of stage I NSCLC patients undergoing operation between 1993 and 2002. We compared and evaluated the relationship between patient characteristics and prognosis after VATS and open lobectomy. We focused particularly on histological type, classifying it into four subgroups; (1) bronchioloalveolar carcinoma (BAC), (2) mixed BAC + papillary adenocarcinoma (BAC + Pap), (3) other adenocarcinoma (Other adeno), (4) squamous cell carcinoma + others (Sq + others).<bold>Results: </bold>A total of 165 patients underwent VATS lobectomy, and 123 patients underwent open lobectomy. The 5-year survival rate of the VATS lobectomy group was 94.5% and that of the open lobectomy group was 81.5%. Univariate Cox regression of survival revealed that male, CEA > 5, Other adeno, Sq + others, open lobectomy, and tumor size > 3 cm were significant negative prognostic variables. Multivariate Cox regression of survival revealed that histological subtype and tumor size were independent prognostic factors, but surgical procedure was not an independent prognostic factor.<bold>Comments: </bold>Prognosis after VATS lobectomy was superior to that after open lobectomy, but patient bias influenced the prognosis in favor of VATS lobectomy, and the surgical procedure itself was not a prognostic factor.
- Subjects
PROGNOSIS; CHEST endoscopic surgery; CEREBRAL cortex surgery; LUNG cancer diagnosis; CANCER invasiveness; REGRESSION analysis; ADENOCARCINOMA; THORACIC surgery; COMPARATIVE studies; LUNG cancer; LUNG tumors; RESEARCH methodology; MEDICAL cooperation; PNEUMONECTOMY; RESEARCH; SQUAMOUS cell carcinoma; SURVIVAL; EVALUATION research
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2007, Vol 21, Issue 9, p1607
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-007-9200-5