초록접수 현황
| 16F-276 | 구연 발표 |
Four-arm Robotic Lobectomy has No Benefit Over VATS Lobectomy in Patients with Clinical Stage I Non-small Cell Lung Cancer
Jee Won Suh, Seokkee Lee, Kyoung Sik Narm, Chang Young Lee, Jin Gu Lee, Hyo Chae Paik, Kyung Young Chung, Dae Joon Kim
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Background : We introduced the 4-arm robotic lobectomy (FARL) technique which aims solo surgery in patients with NSCLC. Early outcome and longterm survival of FARL were compared with those of VATSL.
Methods : Prospective enrollment of 20 FARL and 20 VATSL was planned in patients with clinical stage I. Interim analysis for early postoperative outcome was performed after initial 10 cases in each group to test the feasibility and safety of FARL technique. Five-year overall survival was calculated in both groups after the completion of the study.
Results : The study was terminated early because of the safety issues in FARL group after enrollment of 11 FARL patients and 17 VATSL patients from May 2011 to September 2012. There were no differences in baseline characteristics. Lobectomy time and total operation time were significantly longer in FARL group (p=0.003). There were 3 adverse events in FARL group (bleeding in 2, bronchus tear in 1) which necessitated thoracotomy conversion in 1 patient. There were no differences in pain score, length of tube drainage, hospital stay, and complication rates. Pathologic staging revealed that there were 91.7% stage I patients, and 16.6% stage II patients in FARL group; 82.3% stage I patients, 11.8% stage II patients, and 11.8% stage IIIA patients in VATSL group. During follow-up of 48.9 ± 9.5 months, recurrence was identified in 2 (16.7%) patients after FARL, and 3 (23.5%) patients after VATSL (p=0.671). Five-year overall survival was 100% in FARL group and 88.9% in VATSL group (p=0.414), and 5-year disease-free survival was 82.5% in FARL group and 81.9% in VATSL group (p=0.858).
Conclusion : FARL which aims solo surgery could not be recommended because of safety issues. It required longer operation time, and had no benefits over VATSL in terms of pain score, complication rates, the length of hospital stay, and longterm survival.
Methods : Prospective enrollment of 20 FARL and 20 VATSL was planned in patients with clinical stage I. Interim analysis for early postoperative outcome was performed after initial 10 cases in each group to test the feasibility and safety of FARL technique. Five-year overall survival was calculated in both groups after the completion of the study.
Results : The study was terminated early because of the safety issues in FARL group after enrollment of 11 FARL patients and 17 VATSL patients from May 2011 to September 2012. There were no differences in baseline characteristics. Lobectomy time and total operation time were significantly longer in FARL group (p=0.003). There were 3 adverse events in FARL group (bleeding in 2, bronchus tear in 1) which necessitated thoracotomy conversion in 1 patient. There were no differences in pain score, length of tube drainage, hospital stay, and complication rates. Pathologic staging revealed that there were 91.7% stage I patients, and 16.6% stage II patients in FARL group; 82.3% stage I patients, 11.8% stage II patients, and 11.8% stage IIIA patients in VATSL group. During follow-up of 48.9 ± 9.5 months, recurrence was identified in 2 (16.7%) patients after FARL, and 3 (23.5%) patients after VATSL (p=0.671). Five-year overall survival was 100% in FARL group and 88.9% in VATSL group (p=0.414), and 5-year disease-free survival was 82.5% in FARL group and 81.9% in VATSL group (p=0.858).
Conclusion : FARL which aims solo surgery could not be recommended because of safety issues. It required longer operation time, and had no benefits over VATSL in terms of pain score, complication rates, the length of hospital stay, and longterm survival.
책임저자: Dae Joon Kim
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Jee Won Suh, E-mail : suh_1225@yuhs.ac