초록접수 현황
| 15F-103 | 구연 발표 |
Comparative Analysis of Long-term Outcomes of Lobectomy between VATS and Thoracotomy for Clinical N1 Lung Cancer
박병준, 최용수, 신수민, 조종호, 김홍관, 김진국, 조재일, 심영목
성균관대학교 의과대학 삼성서울병원 흉부외과학교실
Background : The aim of this study was to analyze the oncological efficacy of video-assisted thoracoscopic surgery (VATS) for clinical N1 disease in non-small cell lung cancer (NSCLC).
Methods : From 2007 to 2012, 147 patients received lobectomy for clinical T1a-2aN1M0 NSCLC with curative intent. Patients with double primary cancer or previous history of other malignancy were excluded. Patients who required pulmonary angioplasty or bronchial sleeve resection were also excluded. Operative and long-term outcomes of VATS group (n = 70) were compared with thoracotomy group (n = 77). Mean follow up period was 37±1.8 months and there was no significant difference between two groups.
Results : Patients in the thoracotomy group were significantly older (64±1.1 vs. 60±1.1 years old, p = 0.004) and male patients were more predominant (57% vs. 40%, p = 0.031) than the VATS group. Tumor was also slightly bigger in the thoracotomy group (3.4±0.1 vs. 2.9±0.1 cm, p = 0.001). The pathologic stage did not show significant differences, however the proportion of pathologic N1 disease was significantly higher in the thoracotomy group (47% vs. 24%, p = 0.005). The 90-day mortality showed no difference between the VATS group (n = 2) and the thoracotomy group (n = 3). Postoperative complication rate showed no significant difference between the VATS group (31%) and the thoracotomy group (39%). The 5-year overall survivals were 78% in the VATS group and 65% in the thoracotomy group which showed no significant differences (p = 0.155). The 5-year disease-free survivals were 46% in both groups. During the follow up, local recurrence rates including ipsilateral pleura were similar between the VATS group (15%) and the thoracotomy group (14%). In multivariate analysis, age, gender, size of tumor, and VATS did not affect long-term survival including overall and disease-free survival. In subgroup analyses of pathologic N1 disease, the VATS group showed similar 5-year overall (61% vs. 59%, p = 0.591) and disease-free survival (33% vs. 45%, p = 0.471) with the thoracotomy group.
Conclusion : VATS lobectomy for clinical N1 lung cancer showed similar long-term outcomes compared to thoracotomy.
Methods : From 2007 to 2012, 147 patients received lobectomy for clinical T1a-2aN1M0 NSCLC with curative intent. Patients with double primary cancer or previous history of other malignancy were excluded. Patients who required pulmonary angioplasty or bronchial sleeve resection were also excluded. Operative and long-term outcomes of VATS group (n = 70) were compared with thoracotomy group (n = 77). Mean follow up period was 37±1.8 months and there was no significant difference between two groups.
Results : Patients in the thoracotomy group were significantly older (64±1.1 vs. 60±1.1 years old, p = 0.004) and male patients were more predominant (57% vs. 40%, p = 0.031) than the VATS group. Tumor was also slightly bigger in the thoracotomy group (3.4±0.1 vs. 2.9±0.1 cm, p = 0.001). The pathologic stage did not show significant differences, however the proportion of pathologic N1 disease was significantly higher in the thoracotomy group (47% vs. 24%, p = 0.005). The 90-day mortality showed no difference between the VATS group (n = 2) and the thoracotomy group (n = 3). Postoperative complication rate showed no significant difference between the VATS group (31%) and the thoracotomy group (39%). The 5-year overall survivals were 78% in the VATS group and 65% in the thoracotomy group which showed no significant differences (p = 0.155). The 5-year disease-free survivals were 46% in both groups. During the follow up, local recurrence rates including ipsilateral pleura were similar between the VATS group (15%) and the thoracotomy group (14%). In multivariate analysis, age, gender, size of tumor, and VATS did not affect long-term survival including overall and disease-free survival. In subgroup analyses of pathologic N1 disease, the VATS group showed similar 5-year overall (61% vs. 59%, p = 0.591) and disease-free survival (33% vs. 45%, p = 0.471) with the thoracotomy group.
Conclusion : VATS lobectomy for clinical N1 lung cancer showed similar long-term outcomes compared to thoracotomy.
책임저자: 최용수
성균관대학교 의과대학 삼성서울병원 흉부외과학교실
연락처 : 박병준, Tel: 02-2148-1696 , E-mail : bj80.park@samsung.com
