초록접수 현황
| 16F-194 | 구연 발표 |
Long-term Outcome of Videovideo-assisted Thoracoscopic Thoracoscopic Surgery Surgery Versus Thoracotomy Thoracotomy for Pathological N1 Stage Non-small Cell Lung Cancer
Su Kyung Hwang, Seung-Il Park, Dong Kwan Kim, Yong Hee Kim, Se Hoon Choi, Kanghoon Lee, Jin San Bok, Hanpil Lee, Byungkwon Chong, Hyeong Ryul Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
Background : Application of video-assisted thoracoscopic surgery (VATS) was noted in several studies on early stage non-small cell lung cancer. However, it has not been evaluated in advanced stage non-small cell lung cancer. We compared the oncologic outcomes between VATS and open thoracotomy retrospectively, by using propensity score matching.
Methods : We evaluated 276 consecutive patients who underwent lung resection surgery for pathologic N1 stage non-small cell lung cancer between January 2000 and December 2011 via a retrospective chart review. We used a propensity score matching analysis for comparing VATS and thoracotomy except clinical T3 and T4 stage patients (based on age, sex, smoking, FEV1,DLco, and clincal T stage).
Results : We performed open thoracotomy in 218 patients and VATS in 58 patients. Patient’s demographics were similar between VATS and thoracotomy. However, VATS patients had smaller tumor size than open group. (Clinical T1 stage, p=0.012). The difference in the 5-year survival rate for the pathological stage was not statistically significant between the video-assisted thoracoscopic and thoracotomy groups (pT1; 62.9% vs. 37.6%, p=0.449, pT2; 58.3% vs. 57.6%, p=0.700, pT3; 37.5% vs. 53.3%, p=0.413). The 5-year disease-free survival rate was also similar between the two groups (pT1; 42.8% vs. 58.5%, p=0.985, pT2; 55.7% vs. 57.0%, p=0.885, pT3; 53.4% vs. 62.8%, p=0.367). The propensity matching group is in 156 patients (46 VATS and 110 thoracotomy). Median operative time and median total number of lymph nodes retrieved was similar between two groups (p=0.605, p=0.086). However, the hospital stay duration and the chest tube indwelling time were significantly shorter in the VATS group compared to in the open group.
Conclusion : VATS for patients with pathological N1 stage non-small cell lung cancer appears to have long-term outcomes of survival and recurrence similar to those with thoracotomy. Therefore, VATS is a feasible approach for patients with pathological N1 stage non-small cell lung cancer.
Methods : We evaluated 276 consecutive patients who underwent lung resection surgery for pathologic N1 stage non-small cell lung cancer between January 2000 and December 2011 via a retrospective chart review. We used a propensity score matching analysis for comparing VATS and thoracotomy except clinical T3 and T4 stage patients (based on age, sex, smoking, FEV1,DLco, and clincal T stage).
Results : We performed open thoracotomy in 218 patients and VATS in 58 patients. Patient’s demographics were similar between VATS and thoracotomy. However, VATS patients had smaller tumor size than open group. (Clinical T1 stage, p=0.012). The difference in the 5-year survival rate for the pathological stage was not statistically significant between the video-assisted thoracoscopic and thoracotomy groups (pT1; 62.9% vs. 37.6%, p=0.449, pT2; 58.3% vs. 57.6%, p=0.700, pT3; 37.5% vs. 53.3%, p=0.413). The 5-year disease-free survival rate was also similar between the two groups (pT1; 42.8% vs. 58.5%, p=0.985, pT2; 55.7% vs. 57.0%, p=0.885, pT3; 53.4% vs. 62.8%, p=0.367). The propensity matching group is in 156 patients (46 VATS and 110 thoracotomy). Median operative time and median total number of lymph nodes retrieved was similar between two groups (p=0.605, p=0.086). However, the hospital stay duration and the chest tube indwelling time were significantly shorter in the VATS group compared to in the open group.
Conclusion : VATS for patients with pathological N1 stage non-small cell lung cancer appears to have long-term outcomes of survival and recurrence similar to those with thoracotomy. Therefore, VATS is a feasible approach for patients with pathological N1 stage non-small cell lung cancer.
책임저자: Hyeong Ryul Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
발표자: Su Kyung Hwang, E-mail : victorylina@naver.com