Long-term survival of robotic lobectomy for non-small cell lung cancer: a literature review

Sara Ricciardi,Federico Davini,Gaetano Romano,Carmelina C Zirafa,Franca M A Melfi

doi:10.20517/2574-1225.2019.50

Sara Ricciardi, Federico Davini + Show 3 more

Open Access

https://doi.org/10.20517/2574-1225.2019.50

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Abstract

Even though robotic-assisted surgery is increasingly used for resection of non-small cell lung cancer (NSCLC), data on long-term oncologic outcomes of robotic surgery are still not well defined. The primary endpoint of this review is to analyse the long-term results of robotic lobectomy in NSCLC patients. A systematic research was performed using the PubMed database. Articles published from January 2008 to January 2019 were included. We excluded studies that did not provide results for the long-term outcomes of robotic lobectomy, studies that had fewer than 50 cases and ones that focused on results of sub-lobar resections. Therefore, ten eligible studies were included in this analysis. In total, 2873 patients, with a mean age ranging between 66 and 68 years, who underwent robotic lobectomy for NSCLC, were analysed. Most patients (81%) had early-stage disease. The five-year overall survival for stage I disease fluctuated between 77% and 100%. The five-year disease-free survival was reported to be near 73%. We can conclude that robotic assisted lobectomy is an effective minimally-invasive procedure for lung resection. The current literature shows that robotic lobectomy is associated with long-term survival and lasting disease-free survival, equivalent to those reached by video-assisted thoracic surgery and open approach.

Highlights

Surgical resection of non-small-cell lung cancer (NSCLC) is the preferred local treatment modality for operable disease and lobectomy remains the gold standard treatment in early-stage lung cancer[1]
minimally invasive surgery (MIS) [including video-assisted thoracic surgery (VATS) and robot-assisted surgery] has become the preferred approach in patients with no contraindications, given that the less invasive approach does not compromise the oncologic cancer outcomes and is associated with better short-term results compared to thoracotomy[2]
Recent data have reported an important increase in VATS and robotic lobectomy versus open procedures and several studies have shown that MIS lobectomy results in comparable oncologic outcomes to those of open approach[3,4]

Summary

Introduction

Surgical resection of non-small-cell lung cancer (NSCLC) is the preferred local treatment modality for operable disease and lobectomy remains the gold standard treatment in early-stage lung cancer[1]. Regardless of the approach, the oncologic principles remain unchanged: the achievement of negative margins (R0 resection) and a systematic lymph node dissection; the open approach for lobectomy remains the cornerstone with which the results of the other techniques are compared. Recent data have reported an important increase in VATS and robotic lobectomy versus open procedures and several studies have shown that MIS lobectomy results in comparable oncologic outcomes to those of open approach[3,4]. Level 1 evidence does not exist and data on long-term outcomes for NSCLC patients treated with robotic approach are still lacking[5]

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