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Video-assisted thoracoscopic surgery for stage I non-small cell lung cancer: long-term survival and prognostic factors

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Tumor Biology

Abstract

The purpose of this study was to evaluate the long-term outcomes of video-assisted thoracoscopic surgery (VATS) major pulmonary resection in patients with stage I non-small cell lung cancer (NSCLC). Of the 411 stage I patients, 318 (77.4 %) underwent complete VATS (c-VATS), while 89 (21.7 %) underwent assisted VATS (a-VATS). There were no intraoperative deaths. There were three deaths (0.7 %) within 30 postoperative days. The 1-, 3-, and 5-year survival rates were 95.1 % (95 % CI, 92.9–97.3 %), 83.1 % (95 % CI, 79.2–87.0 %), and 73.4 % (95 % CI, 68.1–78.7 %), respectively. Univariate analysis by log-rank test revealed that tumor-node-metastasis (TNM) stage, primary tumor (pT) status, and type of resection were statistically significant factors affecting overall survival (OS; P = 0.029, P = 0.025, and P = 0.005, respectively). Less acute TNM stage and less extensive resection were significantly predictive for longer OS by multivariate analysis as well (P = 0.024 and P = 0.006, respectively). In experienced hands, c-VATS or a-VATS can be considered as an alternative to traditional incision in patients with stage I NSCLC. Lower TNM stage and less extensive resection were significantly predictive for better OS. A prospective randomized controlled study on a larger scale is required to reach definitive conclusions regarding the efficacy of VATS relative to other techniques.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease. No. 151, Yanjiang Rd, Guangzhou, 510120, Guangdong Province, People’s Republic of China

    Xinguo Xiong, Wenlong Shao, Weiqiang Yin, Xin Xu, Hanzhang Chen, Yuan Qiu & Jianxing He

  2. Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, Guangdong Province, China

    Xinguo Xiong, Wenlong Shao, Weiqiang Yin, Xin Xu, Hanzhang Chen, Yuan Qiu & Jianxing He

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  1. Xinguo Xiong
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  2. Wenlong Shao
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  4. Xin Xu
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Correspondence to Jianxing He.

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Xiong, X., Shao, W., Yin, W. et al. Video-assisted thoracoscopic surgery for stage I non-small cell lung cancer: long-term survival and prognostic factors. Tumor Biol. 34, 3389–3396 (2013). https://doi.org/10.1007/s13277-013-0911-z

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  • DOI: https://doi.org/10.1007/s13277-013-0911-z

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