Background
Methods
Patient characteristics
No. of patiens (%) | VATS (n = 114) | Thoracotomy (n = 46) | p | |
---|---|---|---|---|
Gender | 0.002 | |||
Male | 84(52.5) | 51 | 33 | |
Female | 76(47.5) | 63 | 13 | |
Age | 0.1001 | |||
≤70 | 85(53.1) | 58 | 27 | |
> | 75(46.9) | 56 | 19 | |
Pathology | 0.1533 | |||
Adenocarcinoma | 123(769) | 91 | 31 | |
Squamous cell ca. | 28(17.5) | 17 | 11 | |
Large cell ca. | 3(1.9) | 3 | 0 | |
Others | 6(3.7) | 3 | 3 | |
Tumor diameter (cm) | 0.895 | |||
≤3.0 | 138(86.3) | 100 | 38 | |
3.0< | 22(13.7) | 14 | 8 | |
pN | 0.1706 | |||
N0 | 141(88.1) | 103 | 38 | |
N1/N2 | 19(11.9) | 11 | 8 | |
Pleural involvement | 0.2413 | |||
Negative | 122(76.2) | 93 | 29 | |
Positive | 8(23.8) | 21 | 17 | |
Lymphovascular involvement | 0.0025 | |||
Negative | 135(84.4) | 98 | 37 | |
Positive | 25(15.6) | 16 | 9 | |
Vascular involvement | 0.0126 | |||
Negative | 120(75.0) | 93 | 27 | |
Positive | 40(25.0) | 21 | 19 | |
p-stage | 0.2611 | |||
IA | 108(67.5) | 82(71.9) | 26(56.5) | |
IB | 30(18.8) | 20 | 10 | |
IIA | 10(6.3) | 6 | 4 | |
IIB | 3(1.8) | 1 | 2 | |
IIIA | 9(5.6) | 5 | 4 | |
Recurrence | 160(100) | 12 | 10 | 0.0623 |
Death | 160(100) | 6 | 9 | 0.005 |
B1eeding (g) | 160(100) | 118.1 ± 154.3 | 321.6 ± 352.4 | <0.0001 |
Surgery time (min.) | 160(100) | 198.3 ± 50.2 | 205.1 ± 60.9 | 0.4662 |
Preoperative staging
Surgical procedures
Histopathological examination
Treatment and follow-up
Statistical analysis
Results
Disease-free and overall survival
Accuracy of preoperative staging
Total (n = 160) | VATS (n = 114) | Thoracotomy (n = 46) | |
---|---|---|---|
Tumor diameter > 3.0 cm | 20 (12.5%) | 14 (12.3%) | 8 (17.4%) |
pNl or pN2 | 19 (11.9%) | 11 (9.6%) | 8 (17.4%) |
Positive pla
| 26 (16.3%) | 17 (14.9%) | 9 (19.6%) |
Recurrence
VATS (13 lesions) | Thoracotomy (14 lesions) | |
---|---|---|
Carcinomatous pleuritis | 1 | 4 |
Mediastinal LNa metastasis | 0 | 2 |
Local recurrence | 1 | 6 |
Pulmonary metastasis | 7 | 2 |
Brain metastasis | 1 | 3 |
Bone metastasis | 2 | 1 |
Hepatic metastasis | 0 | 1 |
Others | 2 | 1 |
Distant metastasis | 12 | 8 |
Total
|
13
|
14
|
VATS (n = l 14) | Thoracotomy (n = 46) | |||||
---|---|---|---|---|---|---|
n | 5-year DFS (%) | p | n | 5-year DFS (%) | p | |
Gender | 0.3422 | 0.993 | ||||
Male | 50 | 84.7 | 33 | 78.7 | ||
Female | 64 | 87.2 | 13 | 73.6 | ||
Pathology | 0.8159 | 0.3595 | ||||
Adenocarcinoma | 91 | 84.3 | 32 | 71 | ||
Squamous cell ca. | 16 | 91.7 | 11 | 100 | ||
Others | 7 | 83.3 | 3 | 50 | ||
Tumor diameter (cm) | 0.5551 | 0.2765 | ||||
≤3.0 | 100 | 88.2 | 40 | 75.7 | ||
3.0< | 14 | 68.8 | 6 | 58.4 | ||
pN | <0.0001 | 0.0136 | ||||
N0 | 103 | 90.1 | 38 | 84.7 | ||
N1/N2 | 11 | 51.6 | 8 | 37.5 | ||
Pleural involvement | 0.0174 | 0.0036 | ||||
Negative | 97 | 90.3 | 37 | 87 | ||
Positive | 17 | 57.1 | 9 | 41.7 | ||
Lymphovascular involvement | 0.0536 | 0.0118 | ||||
Negative | 93 | 88.6 | 27 | 91.6 | ||
Positive | 21 | 73.8 | 19 | 53.7 | ||
Vascular involvement | 0.4972 | 0.0096 | ||||
Negative | 92 | 87.2 | 29 | 88 | ||
Positive | 22 | 79.7 | 17 | 58.1 |
a. VATS group
| |||
Variable
|
Hazard ratio
|
95% CI.
|
p
|
pN0 | 015 | 0.043-0.516 | 0.0026 |
Negative pla
| 0.389 | 0.111-1.369 | 0.1415 |
b. Thoracotomy group
| |||
Variable
|
Hazard ratio
|
95% CI.
|
p
|
pN0 | 0.243 | 0.049-1.210 | 0.0841 |
Negative pla
| 0.077 | 0.005-1.186 | 0.0986 |
Negative lyb
| 0.363 | 0.067-1.973 | 0.2407 |
Negative vc
| 0.893 | 0.138-5.764 | 0.9057 |