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Comparative Study
. 2018 Dec 17;13(1):128.
doi: 10.1186/s13019-018-0813-7.

Video assisted thoracic surgery vs. thoracotomy for locally advanced lung squamous cell carcinoma after neoadjuvant chemotherapy

Likui Fang  1 , Luming Wang  1 , Yiqing Wang  1 , Wang Lv  1 , Jian Hu  2
Affiliations
Comparative Study

Video assisted thoracic surgery vs. thoracotomy for locally advanced lung squamous cell carcinoma after neoadjuvant chemotherapy

Likui Fang et al. J Cardiothorac Surg. .

Abstract

Background: Surgery is an important part of multidisciplinary treatment strategy for locally advanced lung squamous cell carcinoma (LSCC), but insufficient evidence supports the feasibility and safety of video assisted thoracic surgery (VATS) following neoadjuvant chemotherapy for locally advanced LSCC. This study aims to compare perioperative data and long-term survival of locally advanced LSCC patients between VATS and thoracotomy after neoadjuvant chemotherapy.

Methods: We retrospectively collected the clinical and pathological information of patients with locally advanced LSCC who underwent surgical resection after neoadjuvant chemotherapy from October 2013 to October 2017. All patients were divided into two groups (thoracotomy and VATS) and were compared the differences in perioperative, oncological and survival outcomes.

Results: A total of 81 patients were analyzed in this study (67 thoracotomy and 14 VATS). VATS provided less postoperative pain (P = 0.005) and produced less volume of chest drainage (P = 0.019) than thoracotomy, but the number of resected lymph nodes was less in VATS group (P = 0.011). However, there was no significant difference in the number of resected lymph node stations and the rate of nodal upstaging between two groups. The mean disease free survival (DFS) was 32.7 ± 2.7 months for the thoracotomy group and 31.8 ± 3.0 months for the VATS group (P = 0.335); the corresponding overall survival (OS) was 41.7 ± 2.2 months and 36.4 ± 4.1 months (P = 0.925).

Conclusion: In selected patients with locally advanced LSCC, VATS played a positive role in postoperative recovery and associated similar survival outcome compared with thoracotomy after neoadjuvant chemotherapy.

Keywords: Locally advanced lung squamous cell carcinoma; Neoadjuvant chemotherapy; Thoracotomy; Video assisted thoracic surgery.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the Institutional Review Board of the First Affiliated Hospital of Zhejiang University, School of Medicine.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curves for the disease-free survival of thoracotomy and VATS (P = 0.335)
Fig. 2
Fig. 2
Kaplan-Meier curves for the overall survival of thoracotomy and VATS (P = 0.925)
See this image and copyright information in PMC

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