VATS lobectomy best for NSCLC patient short-term outcomes

By Lynda Williams, Senior medwireNews Reporter

Video-assisted thoracoscopic surgery (VATS) lobectomy offers better short-term outcomes for patients with early-stage non-small-cell lung cancer (NSCLC) than open lobectomy, multi-institutional research confirms.

“We believe that this study adds to the mounting evidence that VATS lobectomy should become the most common surgical approach to the management of early-stage NSCLC in the United States and wherever the resources are available to offer this specialized technique to patients”, recommend Chukwumere Nwogu, from the State University of New York at Buffalo in New York, USA, and co-workers.

The study compared the outcomes of 175 pairs of patients who underwent VATS or open lobectomy for pathological stage I or II NSCLC between 2004 and 2010 at one of 15 institutions.

The 30-day postoperative mortality rate was 1.7% for both the VATS and open surgery groups and, over 60 months of follow-up, neither overall nor disease-free survival significantly differed between the treatment groups.

However, VATS was associated with a significantly shorter hospital stay on average than open surgery (5.4 vs 8.0 days), a significantly reduced risk of a prolonged hospital stay (6.3 vs 8.6%) and a significantly shorter chest tube time (3.3 vs 5.0 days).

Perioperative complications included supraventricular arrhythmia or atrial fibrillation, blood transfusion requirement, pneumonia and atelectasis. Although there was no significant difference in the rate of the individual complications between the groups, VATS patients were significantly less likely to experience any type of perioperative complication than open surgery patients (14.9 vs 25.1%).

VATS patients were also significantly more likely to be discharged directly home than their open surgery counterparts (93.7 vs 90.3%).

“These short-term clinical benefits would be expected to translate to a significant economic benefit”, the researchers observe.

“In this era of diminishing health-care resources, this would be attractive to patients, clinicians, hospitals, and payers alike.”

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