Quality of life and survival after II stage nonsmall cell carcinoma surgery: Video-assisted thoracic surgery versus thoracotomy lobectomy.

PURPOSE: Due to the improvement of thoracoscopic technology and surgeon's ability, plenty of nonsmall cell lung cancer (NSCLC) was treated by video-assisted thoracic surgery (VATS). This study was designed to evaluate the quality of life (QOL) and survival in II stage NSCLC patients following lobectomy, comparing VATS with thoracotomy. METHODS: Between 2010 and 2012, 217 II stage NSCLC patients (VATS: 114 patients, OPEN: 103 patients) were enrolled in a long-standing, prospective observational lung cancer surgery outcomes study. Short-form 36 health survey (SF-36) and time to progression (TTP) were measured to evaluate the QOL and postoperative survival. RESULTS: There were significant differences between the two groups in the preoperative radiation therapy and differentiation, and the VATS group had less postoperative complication, blood loss, intraoperative fluid administration, and shorter length of stay. Statistical analysis of SF-36 questionnaire revealed that VATS group score was higher on seven health dimensions: Bodily pain (BP), energy (EG), general health, physical functioning, mental health, SF, and role-physical (RP), but only BP, EG, and RP have statistical significance. Using survival analysis, there was no significant difference between VATS and OPEN group, in which the mean TTP of VATS group is 18.5 months, while OPEN group is 20 months. CONCLUSIONS: VATS lobectomy tends to score higher on the QOL and functioning scales and has equivalent postsurgical survival compared with OPEN lobectomy for II stage nonsmall cell carcinoma patients.

Duke Scholars

Author Xiaofei Wang Biostatistics & Bioinformatics, Division of Biostatistics