Version 1
: Received: 7 October 2018 / Approved: 8 October 2018 / Online: 8 October 2018 (15:23:21 CEST)
How to cite:
Shaheen, S.; Otoukesh, S.; Jabo, B.; Kaur, M.; Wheeler, N.; Mirshahidi, S.; Zaheer, S.; Mirshahidi, H.R. Can The Advantages Of Video Assisted Thoracoscopic Lobectomy Be Reproduced In A Low Volume Center?. Preprints2018, 2018100152. https://doi.org/10.20944/preprints201810.0152.v1
Shaheen, S.; Otoukesh, S.; Jabo, B.; Kaur, M.; Wheeler, N.; Mirshahidi, S.; Zaheer, S.; Mirshahidi, H.R. Can The Advantages Of Video Assisted Thoracoscopic Lobectomy Be Reproduced In A Low Volume Center?. Preprints 2018, 2018100152. https://doi.org/10.20944/preprints201810.0152.v1
Shaheen, S.; Otoukesh, S.; Jabo, B.; Kaur, M.; Wheeler, N.; Mirshahidi, S.; Zaheer, S.; Mirshahidi, H.R. Can The Advantages Of Video Assisted Thoracoscopic Lobectomy Be Reproduced In A Low Volume Center?. Preprints2018, 2018100152. https://doi.org/10.20944/preprints201810.0152.v1
APA Style
Shaheen, S., Otoukesh, S., Jabo, B., Kaur, M., Wheeler, N., Mirshahidi, S., Zaheer, S., & Mirshahidi, H.R. (2018). Can The Advantages Of Video Assisted Thoracoscopic Lobectomy Be Reproduced In A Low Volume Center?. Preprints. https://doi.org/10.20944/preprints201810.0152.v1
Chicago/Turabian Style
Shaheen, S., Salman Zaheer and Hamid R. Mirshahidi. 2018 "Can The Advantages Of Video Assisted Thoracoscopic Lobectomy Be Reproduced In A Low Volume Center?" Preprints. https://doi.org/10.20944/preprints201810.0152.v1
Abstract
Background:
Video assisted thoracoscopic surgery (VATS) has become the recommended approach for treatment of resectable lung cancer. However, no large randomized clinical trial has been conducted formally comparing surgical resections completed by VATS to those done by open thoracotomy (OT) in low volume centers. The current study sought to assess differences in recurrence-free survival (RFS), overall survival (OS), positive margins and postoperative length of stay (LOS) between VATS and OT lobectomies in our center.
Method:
A single institution retrospective chart review from May 2005 through May 2015 was conducted. All patients diagnosed with stage I through III lung cancer who underwent surgical resection were selected. Patient and tumor characteristics recorded included age at diagnosis, sex, tobacco use, tumor location (side and lobe), stage, size and receipt of chemotherapy or radiotherapy. Chis-square and Wilcoxon-Mann-Whitney tests were used to compare demographics, tumor characteristics and LOS. Multiple logistic and Cox regression analyses were used to compute relative risk (RR) for positive margins and mortality hazard ratios along with 95 percent confidence intervals (95%CI), respectively.
Results:
Of the 235 patients, 101 subjects had VATS while OT was performed in 134 patients. Age at diagnosis, sex, tobacco use, tumor location, and size were comparable for VATS and OT. No significant difference was observed in the relative risk of positive margins for VATS versus OT, RR = 0.56 (95%CI = 0.26, 1.05). However, VATS had shorter median LOS compared to OT (4 vs. 6 days, respectively), p = 0.002. A comparison of VATS versus OT showed no significant difference in the risk of recurrence, HR = 1.21 (95%CI = 0.74, 2.00), or death, HR = 1.34 (95%CI = 0.88, 2.06), in the intent-to-treat population. Similarly, no significant differences in recurrence or mortality risk were observed between VATS versus OT for analyses conducted separately for each cancer stage group or those limited to patients with negative margins.
Conclusion:
Our study indicates that compared to OT, VATS leads to shorter LOS while achieving comparable margins status, recurrence-free and overall survival regardless of tumor stage at diagnosis.
Keywords
video assisted thoracic surgery, open thoracotomy, recurrence-free survival, overall survival, positive margins, postoperative length of stay.
Subject
Medicine and Pharmacology, Surgery
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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