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Surgical outcome of an anatomical resection of clinical stage IA non-small cell lung cancer assisted with a video-thoracoscopy

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Abstract

Purpose

Video-assisted resections of non-small cell lung cancer (NSCLC) are now performed worldwide; however, its validity as an oncologic surgical modality still remains to be elucidated.

Methods

A consecutive series of 139 clinical stage IA NSCLC patients who underwent video-thoracoscopy combined with an access thoracotomy (VATS) or a standard open surgery (OR) were prospectively investigated regarding their status after undergoing a nodal dissection and their disease-free survival.

Results

Both the VATS (72 patients) and OR groups (67 patients) contained comparable populations in terms of age, sex, histological type, and surgical morbidity, and showed comparable operation time and estimated blood loss. The number of dissected nodes on the right/left side was 25.3/19.5 in the VATS group and 25.6/22.9 in the OR group (P = 0.923/0.313). A pathologic examination revealed the proportion of upstaged patients was 18% in the VATS group and 27% in the OR group (P = 0.439). The disease-free survival rates for both groups were almost completely identical, with rates at 5 years of 76.5% and 79.2%, respectively (P = 0.908).

Conclusion

VATS is therefore considered to be an adequate oncologic surgery for clinical stage IA NSCLC, and is also appropriate for the postoperative adjuvant era.

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References

  1. Walker WS. Video-assisted thoracic surgery (VATS) lobectomy: the Edinburgh experience. Semin Thorac Cardiovasc Surg 1998;10:291–299.

    CAS  PubMed  Google Scholar 

  2. Landreneau RJ, Mack MJ, Hazelrigg SR, Nauheim KS, Keenan RJ, Ferson PF. Prevalence of chronic pain after pulmonary resection by thoracotomy or video-assisted thoracic surgery. J Thorac Cardiovasc Surg 1994;107:1079–1086.

    CAS  PubMed  Google Scholar 

  3. McKenna RJ. Lobectomy by video-assisted thoracic surgery with mediastinal node sampling. J Thorac Cardiovasc Surg 1994;107:879–882.

    PubMed  Google Scholar 

  4. Sugi K, Kaneda Y, Esato K. Video-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer. World J Surg 2000;24:27–31.

    Article  CAS  PubMed  Google Scholar 

  5. Kaseda S, Aoki T, Hangai N, Shimizu K. Better pulmonary function and prognosis with video-assisted thoracic surgery than with thoracotomy. Ann Thorac Surg 2000;70:1644–1646.

    Article  CAS  PubMed  Google Scholar 

  6. Roviaro G, Vatsoli F, Vergani C, Nucca O, Maciocco M, Grignani F. Long-term survival after videothoracoscopic lobectomy for stage I lung cancer. Chest 2004;126:725–732.

    Article  PubMed  Google Scholar 

  7. Winton T, Livingston R, Johnson D, Rigas J, Johnston M, Butts C, et al. A prospective randomized trial of adjuvant vinorelbine plus cisplatin vs. observation in resected non small cell lung cancer. N Engl J Med 2005;352:2589–2597.

    Article  CAS  PubMed  Google Scholar 

  8. Douillard JY, Rosell R, De Lena M, Carpagnano F, Ramlau R, Gonzáles-Larriba JL, et al. Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-IIIA non-small-cell lung cancer (Adjuvant Navelbine International Trialist Association [ANITA]): a randomised controlled trial. Lancet Oncol 2006;7:719–727.

    Article  CAS  PubMed  Google Scholar 

  9. Roovers JPW, van der Bom JG, van der Vaart CH, Heintz APM. Hysterectomy and sexual wellbeing: Prospective observational study of vaginal hysterectomy, subtotal abdominal hysterectomy, and total abdominal hysterectomy. Br Med J 2003;327:774–778.

    Article  Google Scholar 

  10. Travis WD, Colby TV, Corrin B, Shimosato Y, Brambilla E. Histological typing of lung and pleural tumours. World Health Organization international histological classification of tumours. Berlin: Springer; 1999.

    Google Scholar 

  11. Mountain CF. Revisions in the international system for staging lung cancer. Chest 1997;111:710–717.

    Google Scholar 

  12. Yoshino I, Ushijima C, Tomiyasu M, Suemitsu R, Ichinose Y, Sugimachi K. Unique minithoracotomy assisted by videothoracoscopy facilitates a maximal wound for resection of primary lung cancer. Surg Endosc 2002;16:148–150.

    Article  CAS  PubMed  Google Scholar 

  13. Kaplan EL, Meier P. Nonparametric estimation from incomplete observation. J Am Stat Assoc 1958;53:457–458.

    Article  Google Scholar 

  14. Petto R, Peto J. Asymptotically efficient rank and invariant procedures. J R Stat Soc (A) 1972;135:185–207.

    Google Scholar 

  15. Cox DR. Regression models and life tables. J R Stat Soc (B) 1972;34:187–220.

    Google Scholar 

  16. Sagawa M, Sato M, Sakurada A, Matsumura Y, Endo C, Handa M, et al. A prospective trial of systematic nodal dissection for lung cancer by video-assisted thoracic surgery: can it be perfect? Ann Thorac Surg 2002;73:900–904.

    Article  PubMed  Google Scholar 

  17. Yoshino I, Baba H, Fukuyama F, Kameyama T, Shikada Y, Tomiyasu M, et al. A time trend of profile and surgical results in 1123 patients with non-small cell lung cancer. Surgery 2002;131:S242–S248.

    Article  PubMed  Google Scholar 

  18. Okada M, Yoshikawa K, Hatta T, Tsubota N. Is segmentectomy with lymph node assessment an alternative to lobectomy for non-small cell lung cancer of 2 cm or smaller. Ann Thorac Surg 2001;71:956–961.

    Article  CAS  PubMed  Google Scholar 

  19. Yamato Y, Koike T, Yoshiya K, Shinohara H, Toyabe S. Results of surgical treatment for small (2 cm or under) adenocarcinoma of the lung. Surg Today 2008;38:109–114.

    Article  PubMed  Google Scholar 

  20. Nakamura N, Kawasaki N, Taguchi M, Kabasawa K. Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis. B J Cancer 2005;92:1033–1037.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Ichiro Yoshino, Masafumi Yamaguchi, Koji Yamazaki, Fumihiro Shoji, Motoharu Hamatake & Yoshihiko Maehara

  2. Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chiba, 260-8670, Japan

    Ichiro Yoshino

Authors
  1. Ichiro Yoshino
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  2. Masafumi Yamaguchi
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  3. Koji Yamazaki
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  4. Fumihiro Shoji
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  5. Motoharu Hamatake
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  6. Yoshihiko Maehara
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Yoshino, I., Yamaguchi, M., Yamazaki, K. et al. Surgical outcome of an anatomical resection of clinical stage IA non-small cell lung cancer assisted with a video-thoracoscopy. Surg Today 40, 719–724 (2010). https://doi.org/10.1007/s00595-009-4121-7

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  • DOI: https://doi.org/10.1007/s00595-009-4121-7

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