Short- and long-term survival between robot-assisted thoracic surgery and video-assisted thoracoscopic surgery for non-small cell lung cancer: A retrospective cohort study
- VernacularTitle:机器人辅助与电视辅助胸腔镜手术治疗 非小细胞肺癌近远期生存差异的 回顾性队列研究
- Author:
Ming CHENG
1
,
2
;
Shiguang XU
3
;
Wei XU
3
;
Renquan DING
3
;
Xingchi LIU
3
;
Boxiao HU
3
;
Bo LIU
3
;
Dazhi LIU
3
;
Hong TENG
3
;
Shumin WANG
3
Author Information
1. 1. Graduate Training Base of General Hospital of Northern Theater Command, Dalian Medical School, Shenyang, 110016, P. R. China
2. 2. Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China
3. Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China
- Publication Type:Journal Article
- Keywords:
Robot-assisted thoracic surgery;
video-assisted thoracoscopic surgery;
lung cancer;
short- and long-term survival;
prognosis;
cohort study
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(09):1133-1139
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the short- and long-term survival of patients with stage T1N0M0 non-small cell lung cancer (NSCLC) undergoing robot-assisted thoracic surgery (RATS) and video-assisted thoracoscopic surgery (VATS). Methods The clinical data of 396 patients with stage T1N0M0 NSCLC treated with RATS or VATS in our hospital from 2012 to 2019 were retrospectively analyzed. There were 209 males and 187 females, with a mean age of 61.58±8.67 years. According to surgical procedures, they were separated into two groups: a RATS group (n=157) and a VATS group (n=239). The two groups were compared in terms of the survival and prognosis-influencing factors. Results The intraoperative blood loss and postoperative 24 h drainage volume in the RATS group were less than those in the VATS group (48±42 mL vs. 182±231 mL, P<0.001; 250±119 mL vs. 324±208 mL, P<0.001). The groups and number of dissected lymph node in the RATS group were more than those of the VATS group (5±2 groups vs. 3±2 groups, P<0.001; 17±9 vs. 11±8, P<0.001). There was no statistical difference in the postoperative 48 h drainage volume (P=0.497), postoperative intubation time (P=0.180) or hospital stay (P=0.313). The survival state and recurrence-free survival state in the VATS group were better than those in the VATS group (1-year survival rate: 98.7% vs. 94.8%, 5-year survival rate: 90.5% vs. 75.8%, 8-year survival rate: 76.9% vs. 62.1%, mean survival time: 93 months vs. 79 months, P=0.005; 1-year recurrence-free survival rate: 97.4% vs. 95.6%, 5-year recurrence-free survival rate: 94.8% vs. 77.8%, 8-year recurrence-free survival rate: 82.6% vs. 64.8%, mean recurrence-free survival time: 95 months vs. 79 months, P=0.004). Univariate analysis showed that surgical method, the groups and the number of dissected lymph nodes were the influencing factors for postoperative overall survival and recurrence-free survival. At the same time, the results of multivariate analysis showed that surgical method was a common independent factor for overall survival and recurrence-free survival. Conclusion RATS can obtain better survival in patients with T1N0M0 NSCLC, and RATS has more thorough lymph node dissection, less intraoperative blood loss and postoperative 24 h drainage volume.
