초록접수 현황
| 20F-006 | 구연 발표 |
Video-Assisted Thoracoscopic Lobectomy is Feasible in Selected Patients with clinical N2 Non-small Cell Lung Cancer
Jae Kwang Yun1, Geun Dong Lee1, Sehoon Choi1, Hyeong Ryul Kim1, Yong-Hee Kim1, Seung-Il Park1, and Dong Kwan Kim1.
¹Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea.
Purpose : We aimed to evaluate the feasibility of video-assisted thoracoscopic surgery (VATS) and its comparability to open thoracotomy in non-small cell lung cancer patients with clinically suspected N2 (cN2) node metastasis.
Methods : The records of 268 consecutive patients who underwent lobectomy from 2007 to 2016 for cN2 disease were reviewed. Using propensity score-based inverse probability of treatment weighting (IPTW), perioperative and long-term survival outcomes were compared.
Results : We performed VATS and open thoracotomy in 121 and 147 patients, respectively. Overall, VATS was preferred in patients with peripherally located tumor (p <0.001). After IPTW-adjustment, all preoperative information became similar between groups. Compared to thoracotomy, VATS was associated with shorter hospitalization (7.9 days vs. 9.2 days, p = 0.039) and earlier adjuvant chemotherapy (36.9 days vs. 43.1 days, p = 0.033), despite equivalent complete resection rates (91.7% vs. 90.5%, p = 0.657) and dissected lymph nodes (31.5 vs. 30.2, p = 0.562). On IPTW-adjusted analysis, overall survival (OS) (52.2% vs. 47.9%, p = 0.341) and recurrence-free survival (RFS) (59.8% vs 44.4%, p = 0.077) at 5 years were also similar between groups. On Cox analysis, VATS was not a significant prognostic factor in patients with cN2 disease (p = 0.320 for OS and p = 0.293 for RFS).
Conclusion : In selected patients with resectable cN2 disease and peripherally located tumor, VATS is feasible, with shorter hospitalization and time to adjuvant chemotherapy, and comparable perioperative and long-term survival outcomes, compared to open thoracotomy.
Methods : The records of 268 consecutive patients who underwent lobectomy from 2007 to 2016 for cN2 disease were reviewed. Using propensity score-based inverse probability of treatment weighting (IPTW), perioperative and long-term survival outcomes were compared.
Results : We performed VATS and open thoracotomy in 121 and 147 patients, respectively. Overall, VATS was preferred in patients with peripherally located tumor (p <0.001). After IPTW-adjustment, all preoperative information became similar between groups. Compared to thoracotomy, VATS was associated with shorter hospitalization (7.9 days vs. 9.2 days, p = 0.039) and earlier adjuvant chemotherapy (36.9 days vs. 43.1 days, p = 0.033), despite equivalent complete resection rates (91.7% vs. 90.5%, p = 0.657) and dissected lymph nodes (31.5 vs. 30.2, p = 0.562). On IPTW-adjusted analysis, overall survival (OS) (52.2% vs. 47.9%, p = 0.341) and recurrence-free survival (RFS) (59.8% vs 44.4%, p = 0.077) at 5 years were also similar between groups. On Cox analysis, VATS was not a significant prognostic factor in patients with cN2 disease (p = 0.320 for OS and p = 0.293 for RFS).
Conclusion : In selected patients with resectable cN2 disease and peripherally located tumor, VATS is feasible, with shorter hospitalization and time to adjuvant chemotherapy, and comparable perioperative and long-term survival outcomes, compared to open thoracotomy.
책임저자: Dong Kwan Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea.
발표자: Jae Kwang Yun, E-mail : janies@nate.com