• Beijing Da Xue Xue Bao · Dec 2011

    Comparative Study

    [Preliminary comparison research of thoracoscopy and thoracotomy lobectomy for clinical N0 and post-operatively pathological N2 non-small cell lung cancer].

    • Feng-wei Li, Guan-chao Jiang, Yun Li, Liang Bu, Fan Yang, Jian-feng Li, Hui Zhao, Yan-guo Liu, Zu-li Zhou, Jun Liu, and Jun Wang.
    • Department of Thoracic Surgery, Peking University People's Hospital, Being 100044, China.
    • Beijing Da Xue Xue Bao. 2011 Dec 18; 43 (6): 861-5.

    ObjectiveTo evaluate the safty, thoroughness and efficacy of the video-assisted thoracoscopic surgery compared with open thoracotomy, in treatment of patients with the preoperative staging of lymph node negative and postoperative pathological mediastinal lymph node positive (cN0-pN2) locally advanced non-small cell lung cancer(NSCLC).MethodsWe performed a retrospective review of 616 patients who underwent either VATS lobectomy or open thoracotomy from July 2000 to December 2009. Of which 386 patients were diagnosed with preoperative staging of lymph node negative(cN0) non-small cell lung cancer. Of the 386 patients 76 were diagnosed with postoperative pathological mediastinal lymph node positive (pN2). Twenty-nine patients were operated by video-assisted thoracoscopic surgery (VATS group), 47 patients were operated by open thoracotomy(T group).The patients' preoperative and intraoperative conditions, postoperative survival and recurrence, etc. were compared.ResultsThe two groups were similar in age, gender distribution, pulmonary function, preoperative complications and the preoperative clinical stage. VATS group was slightly lower than T group in operation time, and blood loss. The station number of mediastinal lymph nodes dissection was (3.3±1.1) vs. (3.3±1.3), P=0.959; the number of lymph nodes dissected (12.7±8.9) vs. (10.5±7.2),P=0.260; positive lymph nodes / lymph nodes dissection 28.7% vs. 32.5%, P=0.592; the postoperative proportion of single-station N2 55.2% vs. 66.0%(P=0.189) in VATS group and T group, respectively. One, three-year disease-free survival rates after operation in VATS and T group were 82.6% vs.69.2%(P=0.088) and 49.3% vs. 51.3% respectively(P=0.996); one, three-year overall survival rates were 84.9% vs. 71.2%(P=0.149) and 64.0% vs. 42.7% (P=0.121). Both groups had the similar pattern of recurrence, most of which were distant metastases.ConclusionWith respect to the safety,thoroughness and recent effect, VATS is not inferior to open thoracotomy in the treatment of cN0-pN2 non-small cell lung cancer.

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