Long-term outcomes of video-assisted lobectomy in non-small cell lung cancer

Asian Cardiovascular and Thoracic Annals - Tập 29 Số 4 - Trang 318-326 - 2021
Trần Minh Bảo Luân1,2, Ho Tat Bang3,2, Nguyen Lam Vuong4, Le Tien Dung5, Trung Tin Nguyen6, Tran Quyet Tien1, Nguyễn Hoài Nam1
1Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
2Thoracic and Vascular Department, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
3Department of Health Organization and Management, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
4Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
5Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam
6Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam

Tóm tắt

Background Video-assisted thoracoscopic surgery lobectomy combined with lymphadenectomy is widely utilized worldwide for treating non-small cell lung cancer. We evaluated the long-term survival outcomes of this approach and determined the prognostic factors of overall survival. Methods This prospective observational study was performed in patients with non-small cell lung cancer who were subjected to video-assisted lobectomy and lymphadenectomy from 2012 to 2016. Independent prognostic factors were determined via uni- and multivariable Cox models. Results There were 109 patients with the mean age of 59.2 years and males accounted for 54.1%. Postoperative staging determined 22.9% of stage IA, 31.2% of stage IB, 16.5% of stage IIA and 29.4% of stage IIIA. Median follow-up time was 27 months. The overall survival rate after 1, 2, 3, 4 and 5 years was 100%, 85.9%, 65.3%, 55.9% and 55.9%, respectively. In univariable analysis, smoking (hazard ratio (HR) [95% confidence interval (CI)]: 2.50 [1.18–5.31]), Tumor--nodes--metastases (TNM) stage (IIA: 7.60 [1.57–36.9]; IIIA: 14.3 [3.28–62.7] compared to IA), histological differentiation (moderately differentiated: 4.91 [1.04–23.2]; poorly differentiated: 8.25 [1.91–35.6] compared to well differentiated), lymph node size ≥1 cm (8.22 [3.11–21.7]), tumour size ≥3 cm (4.24 [1.01–17.9]), radical lymphadenectomy (6.67 [3.14–14.2]) were identified as prognostic factors of the long-term survival. In multivariable analysis, only radical lymphadenectomy was an independent prognostic factor (HR [95% CI]: 3.94 [1.41–11.0]). Conclusion Video-assisted thoracoscopic lobectomy combined with lymphadenectomy is feasible, safe and effective for the treatment of non-small cell lung cancer. The long-term outcomes of this method are favourable, especially at the early stage of cancer.

Từ khóa


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Thông tin xuất bản

Asian Cardiovascular and Thoracic Annals

Tập 29 Số 4

318-326

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