Surgical Effectiveness of Uniportal-VATS Lobectomy Compared to Open Surgery in Early-Stage Lung Cancer
BackgroundAlthough the feasibility and safety of Uniportal-Video-Assisted thoracic surgery (U-VATS) has been proven, its surgical effectiveness is still debated. The aim of this study is to assess the equivalence of the U-VATS approach compared with an open technique in terms of surgical (nodal-upst...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.840070/full |
| _version_ | 1819282052826005504 |
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| author | Dania Nachira Maria Teresa Congedo Diomira Tabacco Carolina Sassorossi Giuseppe Calabrese Mahmoud Ismail Maria Letizia Vita Leonardo Petracca-Ciavarella Stefano Margaritora Elisa Meacci |
| author_facet | Dania Nachira Maria Teresa Congedo Diomira Tabacco Carolina Sassorossi Giuseppe Calabrese Mahmoud Ismail Maria Letizia Vita Leonardo Petracca-Ciavarella Stefano Margaritora Elisa Meacci |
| author_sort | Dania Nachira |
| collection | DOAJ |
| description | BackgroundAlthough the feasibility and safety of Uniportal-Video-Assisted thoracic surgery (U-VATS) has been proven, its surgical effectiveness is still debated. The aim of this study is to assess the equivalence of the U-VATS approach compared with an open technique in terms of surgical (nodal-upstaging, complications, and post-operative results) and short-term survival outcomes.MethodsThe clinical data of patients undergoing lobectomy for NSCLC at our center, from January 2014 to December 2019, were analyzed retrospectively. All patients undergoing open or U-VATS lobectomy with lymphadenectomy for early-stage lung cancer (cT1-T3N0, stages IA-IIB) were included in the study. Only 230 patients satisfied the inclusion criteria. Group bias was reduced through 1:1 propensity score matching, which resulted in 46 patients in each group (open surgery and U-VATS).ResultsThe intra- and post-operative mortality were null in both groups. There was no difference in the post-operative complications (p: 1.00) between U-VATS and open lobectomy. There was also no recorded difference in the pathological nodal up-staging [11 (23.9%) after thoracotomy vs. 8 (17.4%) after U-VATS, p: 0.440). The chest tube duration was longer in the open group (p: 0.025), with a higher post-operative pain (p: 0.001). Additionally, the 3-year overall survival (OS) was 78% after U-VATS lobectomy vs. 74% after open lobectomy (p: 0.204), while 3-year disease-specific survival (DSS) was 97 vs. 89% (p: 0.371), respectively. The 3-year disease-free survival (DFS) was 62% in the U-VATS group and 66% in the thoracotomy group, respectively (p: 0.917).ConclusionsUniportal-VATS lobectomy for the treatment of early-stage lung cancer seems to be a safe and effective technique with similar surgical and short-term survival outcomes as open surgery, but with lower post-operative pain and shorter in-hospital stay. |
| first_indexed | 2024-12-24T01:09:28Z |
| format | Article |
| id | doaj.art-5c3eb6e456714711a3c336a5d986f20a |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-24T01:09:28Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-5c3eb6e456714711a3c336a5d986f20a2022-12-21T17:23:04ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-03-01910.3389/fsurg.2022.840070840070Surgical Effectiveness of Uniportal-VATS Lobectomy Compared to Open Surgery in Early-Stage Lung CancerDania Nachira0Maria Teresa Congedo1Diomira Tabacco2Carolina Sassorossi3Giuseppe Calabrese4Mahmoud Ismail5Maria Letizia Vita6Leonardo Petracca-Ciavarella7Stefano Margaritora8Elisa Meacci9Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli,” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli,” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli,” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli,” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli,” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Thoracic Surgery, Klinikum Ernst von Bergmann Potsdam, Academic Hospital of the Charité-Universitätsmedizin Humboldt University Berlin, Potsdam, GermanyDepartment of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli,” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli,” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli,” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli,” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Rome, ItalyBackgroundAlthough the feasibility and safety of Uniportal-Video-Assisted thoracic surgery (U-VATS) has been proven, its surgical effectiveness is still debated. The aim of this study is to assess the equivalence of the U-VATS approach compared with an open technique in terms of surgical (nodal-upstaging, complications, and post-operative results) and short-term survival outcomes.MethodsThe clinical data of patients undergoing lobectomy for NSCLC at our center, from January 2014 to December 2019, were analyzed retrospectively. All patients undergoing open or U-VATS lobectomy with lymphadenectomy for early-stage lung cancer (cT1-T3N0, stages IA-IIB) were included in the study. Only 230 patients satisfied the inclusion criteria. Group bias was reduced through 1:1 propensity score matching, which resulted in 46 patients in each group (open surgery and U-VATS).ResultsThe intra- and post-operative mortality were null in both groups. There was no difference in the post-operative complications (p: 1.00) between U-VATS and open lobectomy. There was also no recorded difference in the pathological nodal up-staging [11 (23.9%) after thoracotomy vs. 8 (17.4%) after U-VATS, p: 0.440). The chest tube duration was longer in the open group (p: 0.025), with a higher post-operative pain (p: 0.001). Additionally, the 3-year overall survival (OS) was 78% after U-VATS lobectomy vs. 74% after open lobectomy (p: 0.204), while 3-year disease-specific survival (DSS) was 97 vs. 89% (p: 0.371), respectively. The 3-year disease-free survival (DFS) was 62% in the U-VATS group and 66% in the thoracotomy group, respectively (p: 0.917).ConclusionsUniportal-VATS lobectomy for the treatment of early-stage lung cancer seems to be a safe and effective technique with similar surgical and short-term survival outcomes as open surgery, but with lower post-operative pain and shorter in-hospital stay.https://www.frontiersin.org/articles/10.3389/fsurg.2022.840070/fullNSCLCUniportal-VATSnodal upstagingdisease-free survival (DFS)oncological outcomes |
| spellingShingle | Dania Nachira Maria Teresa Congedo Diomira Tabacco Carolina Sassorossi Giuseppe Calabrese Mahmoud Ismail Maria Letizia Vita Leonardo Petracca-Ciavarella Stefano Margaritora Elisa Meacci Surgical Effectiveness of Uniportal-VATS Lobectomy Compared to Open Surgery in Early-Stage Lung Cancer Frontiers in Surgery NSCLC Uniportal-VATS nodal upstaging disease-free survival (DFS) oncological outcomes |
| title | Surgical Effectiveness of Uniportal-VATS Lobectomy Compared to Open Surgery in Early-Stage Lung Cancer |
| title_full | Surgical Effectiveness of Uniportal-VATS Lobectomy Compared to Open Surgery in Early-Stage Lung Cancer |
| title_fullStr | Surgical Effectiveness of Uniportal-VATS Lobectomy Compared to Open Surgery in Early-Stage Lung Cancer |
| title_full_unstemmed | Surgical Effectiveness of Uniportal-VATS Lobectomy Compared to Open Surgery in Early-Stage Lung Cancer |
| title_short | Surgical Effectiveness of Uniportal-VATS Lobectomy Compared to Open Surgery in Early-Stage Lung Cancer |
| title_sort | surgical effectiveness of uniportal vats lobectomy compared to open surgery in early stage lung cancer |
| topic | NSCLC Uniportal-VATS nodal upstaging disease-free survival (DFS) oncological outcomes |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.840070/full |
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