Uniportal video-assisted thoracoscopic surgery does not increase recurrence rates following pneumonectomy in non-small cell lung cancer: a retrospective study from the National Cancer Center of China.
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Abstract
Background: The safety, feasibility, and potential benefits of uniportal video-assisted thoracoscopic surgery (U-VATS) pneumonectomy remain to be investigated. This study aimed to evaluate the postoperative outcomes, survival prognosis, and recurrence patterns in patients undergoing U-VATS versus those undergoing open pneumonectomy. The feasibility of U-VATS pneumonectomy in patients receiving neoadjuvant systemic therapy was also assessed.
Methods: Patients with non-small cell lung cancer (NSCLC) underwent thoracic surgeries at the Cancer Hospital, Chinese Academy of Medical Sciences (CHCAMS) from January 2017 to December 2022. Among these patients, those who underwent U-VATS or open pneumonectomy were included in our study. Propensity score matching (PSM) with a 3:1 ratio was conducted to balance the baseline characteristics between the groups. We compared perioperative outcomes and recurrence patterns between the two groups.
Results: A total of 457 patients who underwent pneumonectomy were included in our study, with 348 in the open pneumonectomy group and 109 in the U-VATS group. After PSM, 334 patients (231 in the open group and 103 in the U-VATS group) were available for subsequent analyses. Patients who underwent U-VATS pneumonectomy experienced shorter postoperative hospital stays (P<0.001). No significant differences were observed in the 5-year overall survival (OS) rate (P=0.19) or the 5-year recurrence-free survival (RFS) rate (P=0.37) between the two groups. Additionally, subgroup analysis of patients receiving neoadjuvant systemic therapy indicated those in the U-VATS group did not exhibit significant differences in recurrence patterns between the two groups.
Conclusions: Patients with NSCLC undergoing U-VATS pneumonectomy exhibit postoperative outcomes, survival rates, and recurrence patterns that are not inferior to those of patients undergoing open pneumonectomy.
期刊介绍：
Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.
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