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A Minimally Invasive Approach to Lobectomy After Induction Therapy Does Not Compromise Survival.

Publication ,  Journal Article
Yang, C-FJ; Nwosu, A; Mayne, NR; Wang, Y-Y; Raman, V; Meyerhoff, RR; D'Amico, TA; Berry, MF
Published in: Ann Thorac Surg
May 2020

BACKGROUND: The objective of this study was to evaluate the impact of a video-assisted thoracoscopic (VATS) approach on outcomes in patients who underwent lobectomy after induction therapy. METHODS: Outcomes of patients with T2-T4, N0, M0 and T1-T4, N1-N2, M0 non-small-cell lung cancer who received induction chemotherapy or chemoradiation followed by lobectomy in the National Cancer Data Base (2010-2014) were assessed using Kaplan-Meier, propensity score-matched, multivariable logistic regression and Cox proportional hazards analyses. RESULTS: In the National Cancer Data Base, 2887 lobectomy patients met inclusion criteria (VATS 676 [23%]; thoracotomy 2211 [77%]). Of the VATS cases, patients who underwent induction chemoradiation were more likely to undergo conversion (adjusted odds ratio 1.70, P = .05). Compared with an open approach, VATS was associated with decreased length of stay (median: 5 days vs 6 days, P < .01) and no significant differences in 30-day mortality (VATS [1.5% (n = 10)] vs open [2.6% (n = 58)]; P = .13) and 90-day mortality (VATS [3.7% (n = 25)] vs open [5.6% (n = 124)]; P = .14). There were no significant differences in 5-year survival between the VATS and open groups in both the entire cohort (VATS [50.3%] vs open [52.3%]; P = .83) and in a propensity score-matched analysis of 876 patients; furthermore, a VATS approach was not associated with worse survival in multivariable analysis (hazard ratio 1.02; 95% confidence interval 0.86-1.20; P = .83). CONCLUSIONS: In this national analysis, a VATS approach for lobectomy in patients who received induction therapy for locally advanced non-small-cell lung cancer was not associated with worse short-term or long-term outcomes when compared with an open approach.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

May 2020

Volume

109

Issue

5

Start / End Page

1503 / 1511

Location

Netherlands

Related Subject Headings

  • United States
  • Thoracic Surgery, Video-Assisted
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Propensity Score
  • Pneumonectomy
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Middle Aged
 

Citation

APA
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ICMJE
MLA
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Yang, C.-F., Nwosu, A., Mayne, N. R., Wang, Y.-Y., Raman, V., Meyerhoff, R. R., … Berry, M. F. (2020). A Minimally Invasive Approach to Lobectomy After Induction Therapy Does Not Compromise Survival. Ann Thorac Surg, 109(5), 1503–1511. https://doi.org/10.1016/j.athoracsur.2019.09.065
Yang, Chi-Fu Jeffrey, Adaora Nwosu, Nicholas R. Mayne, Yo-Yo Wang, Vignesh Raman, Robert Ryan Meyerhoff, Thomas A. D’Amico, and Mark F. Berry. “A Minimally Invasive Approach to Lobectomy After Induction Therapy Does Not Compromise Survival.Ann Thorac Surg 109, no. 5 (May 2020): 1503–11. https://doi.org/10.1016/j.athoracsur.2019.09.065.
Yang C-FJ, Nwosu A, Mayne NR, Wang Y-Y, Raman V, Meyerhoff RR, et al. A Minimally Invasive Approach to Lobectomy After Induction Therapy Does Not Compromise Survival. Ann Thorac Surg. 2020 May;109(5):1503–11.
Yang, Chi-Fu Jeffrey, et al. “A Minimally Invasive Approach to Lobectomy After Induction Therapy Does Not Compromise Survival.Ann Thorac Surg, vol. 109, no. 5, May 2020, pp. 1503–11. Pubmed, doi:10.1016/j.athoracsur.2019.09.065.
Yang C-FJ, Nwosu A, Mayne NR, Wang Y-Y, Raman V, Meyerhoff RR, D’Amico TA, Berry MF. A Minimally Invasive Approach to Lobectomy After Induction Therapy Does Not Compromise Survival. Ann Thorac Surg. 2020 May;109(5):1503–1511.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

May 2020

Volume

109

Issue

5

Start / End Page

1503 / 1511

Location

Netherlands

Related Subject Headings

  • United States
  • Thoracic Surgery, Video-Assisted
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Propensity Score
  • Pneumonectomy
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Middle Aged