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

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

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. Clinical stage Ⅰ NSCLC patients with radiologic solid tumors who underwent robotic-assisted thoracic surgery (RATS) or V...

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Bibliographic Details
Published in:Clinical lung cancer
Main Authors: Zhang, Jianfeng, Wang, Zhongjie, Wang, Yuming, Yu, Xuewen, Liang, Yanpen, Sun, Changbo, Zhou, Qianjun
Format: Journal Article
Language:English
Published: Elsevier Inc 15-10-2024
Subjects:
Non–small-cell lung cancer
Perioperative outcomes
Propensity score matching
Robotic-assisted thoracic surgery
Video-assisted thoracic surgery
VATS
FDA
LN
MRI
Propensity score matching
RATS
LLL
RLL
DLCO
NCDB
EBUS
RFS
BMI
Perioperative outcomes
Non–small-cell lung cancer
LUL
NSCLC
OS
RUL
PSM
GGO
RML
CT
Robotic-assisted thoracic surgery
MIS
FEV1
Video-assisted thoracic surgery
COPD
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Summary: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. 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). 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). 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. The safety and efficacy of video-assisted thoracic surgical (VATS) versus robotic lobectomy for solid non–small-cell lung cancer (NSCLC) remained unknown. This propensity score matched analysis from a high-volume single center reveals that compared with the VATS approach, RATS had similar long-term survival outcomes in stage I NSCLC with radiologic solid tumors, and was associated with more lymph node dissection. [Display omitted]
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ISSN:1525-7304
1938-0690
1938-0690
DOI:10.1016/j.cllc.2024.10.004