Oncological results of full thoracoscopic major pulmonary resections for clinical Stage I non-small-cell lung cancer.

Lutz, Jon Andri; Seguin-Givelet, Agathe; Grigoroiu, Madalina; Brian, Emmanuel; Girard, Philippe; Gossot, Dominique (2019). Oncological results of full thoracoscopic major pulmonary resections for clinical Stage I non-small-cell lung cancer. European journal of cardio-thoracic surgery, 55(2), pp. 263-270. Oxford University Press 10.1093/ejcts/ezy245

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OBJECTIVES The full thoracoscopic approach to major pulmonary resections is considered challenging and controversial as it might compromise oncological outcomes. The aim of this work was to analyse the results of a full thoracoscopic technique in terms of nodal upstaging and survival in patients with non-small-cell lung carcinoma (NSCLC). METHODS All patients who underwent a full thoracoscopic major pulmonary resection for NSCLC between 2007 and August 2016 were analysed from an 'intent-to-treat' prospective database. Overall survival and disease-free survival were estimated using the Kaplan-Meier curves and comparisons in survival using the log-rank test. RESULTS A total of 648 patients met the inclusion criteria, of whom 621 patients had clinical Stage I and 27 had higher stages (16 oligometastatic patients were excluded from the analysis, 11 cT3 or cT4). The mean follow-up was 34.5 months. There were 40 conversions to thoracotomy (6.3%). Thirty-day or in-hospital mortality was 0.95%. Complications occurred in 29.3% of patients. On pathological examination, 22.5% of clinical Stage I patients were upstaged. Nodal upstaging to N1 or N2 was observed in 15.8% of clinical Stage I patients. Five-year overall survival of the whole cohort was 75% and was significantly different between clinical Stages IA (76%) and IB (70.9%). For tumours <2 cm, no significant difference in overall survival was found for the segmentectomy group compared to the lobectomy group: 74% versus 78.9% (P = 0.634). CONCLUSIONS Long-term survival is not compromised by a full thoracoscopic approach. Our results compared favourably with those of video-assisted techniques.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery
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UniBE Contributor:

Lutz, Jon Andri

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1873-734X

Publisher:

Oxford University Press

Language:

English

Submitter:

Thomas Michael Marti

Date Deposited:

18 Jan 2019 10:24

Last Modified:

21 Nov 2019 04:33

Publisher DOI:

10.1093/ejcts/ezy245

PubMed ID:

30052990

BORIS DOI:

10.7892/boris.123412

URI:

https://boris.unibe.ch/id/eprint/123412

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