Comparison of Long-Term Survival Between Robotic and Video-Assisted Lobectomy for Stage Ⅰ NSCLC With Radiologic Solid Tumors: A Propensity Score Matching Study.

IF 3.3 3区医学 Q2 ONCOLOGY Clinical lung cancer Pub Date : 2024-10-15 DOI:10.1016/j.cllc.2024.10.004

Jianfeng Zhang, Zhongjie Wang, Yuming Wang, Xuewen Yu, Yanpen Liang, Changbo Sun, Qianjun Zhou

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Abstract

Background: To compare the long-term survival between robotic and video-assisted thoracic surgery (VATS) lobectomy for stage Ⅰ non-small-cell lung cancer (NSCLC) with radiologic solid tumors.

Methods: Clinical stage Ⅰ NSCLC patients with radiologic solid tumors who underwent robotic-assisted thoracic surgery (RATS) or VATS lobectomy between 2015 and 2017 were retrospectively reviewed. A propensity score matching analysis was performed to balance the baseline characteristics. The primary end points were overall survival (OS) and recurrence-free survival (RFS).

Results: A total of 518 patients (225 RATS and 293 VATS) were included. After propensity score matching, there were 170 cases in each group. Patients undergoing RATS had shorter operative time than VATS (98.12 min vs. 112.26 min; P < 0.001). The RATS approach resulted in a higher number of resected lymph nodes (LNs) (11.75 vs. 9.77; P < 0.001). The postoperative complication rates were comparable (7.6% vs. 10.0%, P = .566). The rates of 5-year OS and RFS for the RATS and VATS were 92% versus 89% (P = .62) and 82% vs. 86% (P = .70), respectively. Multivariate analysis revealed that the number of resected LNs was significantly associated with overall survival (OR = 1.94 [95% confidence interval [CI]: 1.07-3.51], P = .029).

Conclusion: The long-term survival outcomes of RATS and VATS are similar for c-stage Ⅰ NSCLC with radiologic solid tumors. The use of robotics is associated with more lymph node dissection and shorter operative time. We suggested that the number of examined lymph nodes rather than surgical approaches was associated with overall survival.

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机器人和视频辅助肺叶切除术治疗Ⅰ期NSCLC伴放射性实体瘤的长期生存率比较：倾向得分匹配研究》。

研究背景比较机器人和视频辅助胸腔手术（VATS）肺叶切除术治疗Ⅰ期非小细胞肺癌（NSCLC）放射性实体瘤的长期生存率：对2015年至2017年间接受机器人辅助胸腔手术（RATS）或VATS肺叶切除术的放射性实体瘤临床Ⅰ期NSCLC患者进行回顾性研究。为平衡基线特征，进行了倾向评分匹配分析。主要终点为总生存期（OS）和无复发生存期（RFS）：结果：共纳入 518 例患者（225 例 RATS 和 293 例 VATS）。经过倾向评分匹配后，每组各有 170 例。与 VATS 相比，RATS 患者的手术时间更短（98.12 分钟对 112.26 分钟；P < 0.001）。RATS方法切除的淋巴结（LN）数量更高（11.75 对 9.77；P < 0.001）。术后并发症发生率相当（7.6% 对 10.0%，P = .566）。RATS和VATS的5年OS和RFS率分别为92%对89%（P = .62）和82%对86%（P = .70）。多变量分析显示，切除的LN数量与总生存率显著相关（OR = 1.94 [95% 置信区间 [CI]：1.07-3.51]，P = .029）：结论：对于伴有放射性实体瘤的c期ⅠNSCLC，RATS和VATS的长期生存结果相似。使用机器人与更多的淋巴结清扫和更短的手术时间相关。我们认为，检查淋巴结的数量而非手术方式与总生存率有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical lung cancer 医学-肿瘤学

CiteScore

7.00

自引率

2.80%

发文量

159

审稿时长

24 days

期刊介绍： Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.