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Multicenter Study
. 2018 Feb;155(2):778-786.
doi: 10.1016/j.jtcvs.2017.09.016. Epub 2017 Sep 18.

The long-term survival of robotic lobectomy for non-small cell lung cancer: A multi-institutional study

Robert J Cerfolio  1 , Asem F Ghanim  2 , Mark Dylewski  3 , Giulia Veronesi  4 , Lorenzo Spaggiari  5 , Bernard J Park  6
Affiliations
Multicenter Study

The long-term survival of robotic lobectomy for non-small cell lung cancer: A multi-institutional study

Robert J Cerfolio et al. J Thorac Cardiovasc Surg. 2018 Feb.

Abstract

Objective: Our objective is to report the world's largest series with the longest follow-up of robotic lobectomy for non-small cell lung cancer (NSCLC).

Methods: This was a multi-institutional retrospective review of a consecutive series of patients from 4 institutions' prospective robotic databases.

Results: There were 1339 patients (men 55%, median age 68 years). The median operative time was 136 minutes, median number of lymph nodes was 13 (5 N2 stations and 1 N1), median blood loss was 50 cc, and 4 (0.005%) patients received intraoperative transfusions. Conversions occurred in 116 patients (9%) and for bleeding in 24 (2%). Median length of stay was 3 days. Major morbidity occurred in 8%. The 30-day and 90-day operative mortality was 0.2% and 0.5%, respectively. Follow-up was complete in 99% of patients with a median follow-up of 30 months (range 1-154 months). The 5-year stage-specific survival was: 83% for the 672 patients with stage IA NSCLC, 77% for the 281 patients with stage IB, 68% for the 118 patients with stage IIA, 70% for 99 patients with IIB, 62% for 143 patients with stage IIIA (122 had N2 disease, 73%), and 31% for 8 patients with stage IIIB (none had N3 disease). The cumulative incidence of metastatic NSCLC was 15% (128 patients, 95% confidence interval, 13%-18%). The cumulative incidence of local recurrence in the ipsilateral operated chest was 3% only (26 patients, 95% confidence interval, 2%-5%).

Conclusions: The oncologic results of robotic lobectomy for NSCLC are promising, especially for patients with pathologic N2 disease. However, further follow-up and studies are needed.

Keywords: lung cancer; quality outcomes; robotic surgery; survival.

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Conflict of interest statement

Conflicts of Interest Statement: Dr Cerfolio is a consultant for Intuitive, C-SATS, Bovie, Ethicon, Covidien/Medtronic, Community Health Services, Davol/Bard, Myriad Genetics, KCI an Acelity Company, and Verb Medical. Dr Veronesi was a past proctor for a Medica. Dr Park is on the speakers' bureau for Bard-Davol and was a past proctor for Intuitive Surgical. Dr Dylewski is a consultant for Intuitive surgical, Ethicon, Verb medical, and Bard. All other authors have nothing to disclose with regard to commercial support.

Figures

Figure 1
Figure 1
Overall survival for non–small cell lung cancer after robotic lobectomy. CI, Confidence interval.
Figure 2
Figure 2
Stage-specific survival for non–small cell lung cancer after robotic lobectomy. CI, Confidence interval.
See this image and copyright information in PMC

Comment in

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