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Use and Outcomes of Minimally Invasive Lobectomy for Stage I Non-Small Cell Lung Cancer in the National Cancer Data Base.

Publication ,  Journal Article
Yang, C-FJ; Sun, Z; Speicher, PJ; Saud, SM; Gulack, BC; Hartwig, MG; Harpole, DH; Onaitis, MW; Tong, BC; D'Amico, TA; Berry, MF
Published in: Ann Thorac Surg
March 2016

BACKGROUND: Previous studies have raised concerns that video-assisted thoracoscopic (VATS) lobectomy may compromise nodal evaluation. The advantages or limitations of robotic lobectomy have not been thoroughly evaluated. METHODS: Perioperative outcomes and survival of patients who underwent open versus minimally-invasive surgery (MIS [VATS and robotic]) lobectomy and VATS versus robotic lobectomy for clinical T1-2, N0 non-small cell lung cancer from 2010 to 2012 in the National Cancer Data Base were evaluated using propensity score matching. RESULTS: Of 30,040 lobectomies, 7,824 were VATS and 2,025 were robotic. After propensity score matching, when compared with the open approach (n = 9,390), MIS (n = 9,390) was found to have increased 30-day readmission rates (5% versus 4%, p < 0.01), shorter median hospital length of stay (5 versus 6 days, p < 0.01), and improved 2-year survival (87% versus 86%, p = 0.04). There were no significant differences in nodal upstaging and 30-day mortality between the two groups. After propensity score matching, when compared with the robotic group (n = 1,938), VATS (n = 1,938) was not significantly different from robotics with regard to nodal upstaging, 30-day mortality, and 2-year survival. CONCLUSIONS: In this population-based analysis, MIS (VATS and robotic) lobectomy was used in the minority of patients for stage I non-small cell lung cancer. MIS lobectomy was associated with shorter length of hospital stay and was not associated with increased perioperative mortality, compromised nodal evaluation, or reduced short-term survival when compared with the open approach. These results suggest the need for broader implementation of MIS techniques.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

March 2016

Volume

101

Issue

3

Start / End Page

1037 / 1042

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Thoracic Surgery, Video-Assisted
  • Survival Rate
  • Robotics
  • Retrospective Studies
  • Respiratory System
  • Registries
  • Puerto Rico
  • Propensity Score
 

Citation

APA
Chicago
ICMJE
MLA
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Yang, C.-F., Sun, Z., Speicher, P. J., Saud, S. M., Gulack, B. C., Hartwig, M. G., … Berry, M. F. (2016). Use and Outcomes of Minimally Invasive Lobectomy for Stage I Non-Small Cell Lung Cancer in the National Cancer Data Base. Ann Thorac Surg, 101(3), 1037–1042. https://doi.org/10.1016/j.athoracsur.2015.11.018
Yang, Chi-Fu Jeffrey, Zhifei Sun, Paul J. Speicher, Shakir M. Saud, Brian C. Gulack, Matthew G. Hartwig, David H. Harpole, et al. “Use and Outcomes of Minimally Invasive Lobectomy for Stage I Non-Small Cell Lung Cancer in the National Cancer Data Base.Ann Thorac Surg 101, no. 3 (March 2016): 1037–42. https://doi.org/10.1016/j.athoracsur.2015.11.018.
Yang C-FJ, Sun Z, Speicher PJ, Saud SM, Gulack BC, Hartwig MG, et al. Use and Outcomes of Minimally Invasive Lobectomy for Stage I Non-Small Cell Lung Cancer in the National Cancer Data Base. Ann Thorac Surg. 2016 Mar;101(3):1037–42.
Yang, Chi-Fu Jeffrey, et al. “Use and Outcomes of Minimally Invasive Lobectomy for Stage I Non-Small Cell Lung Cancer in the National Cancer Data Base.Ann Thorac Surg, vol. 101, no. 3, Mar. 2016, pp. 1037–42. Pubmed, doi:10.1016/j.athoracsur.2015.11.018.
Yang C-FJ, Sun Z, Speicher PJ, Saud SM, Gulack BC, Hartwig MG, Harpole DH, Onaitis MW, Tong BC, D’Amico TA, Berry MF. Use and Outcomes of Minimally Invasive Lobectomy for Stage I Non-Small Cell Lung Cancer in the National Cancer Data Base. Ann Thorac Surg. 2016 Mar;101(3):1037–1042.

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

March 2016

Volume

101

Issue

3

Start / End Page

1037 / 1042

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Thoracic Surgery, Video-Assisted
  • Survival Rate
  • Robotics
  • Retrospective Studies
  • Respiratory System
  • Registries
  • Puerto Rico
  • Propensity Score