P1.17-06 Long-Term Oncological Outcome After Thoracoscopic Lobectomy for Non-Small Cell Lung Cancer Patients

Abstract

Thoracoscopic surgery (TS) has been used more commonly as a less invasive procedure for early-stage non-small cell lung cancer (NSCLC) than conventional thoracotomy (TH) in Japan. However, limited evidential data are available to compare the treatment efficacy of TS and TH. The purpose of this study was to retrospectively investigate the difference in the long-term outcome and invasiveness of TS and TH. Total 1,166 NSCLC patients who underwent surgery between 2005 and 2013 were enrolled. Of these, 844 patients underwent surgery via TH and 322 via TS. We compared several clinicopathological factors and the long-term outcome between the two groups. We performed propensity score matching analysis to minimize differences in the patient background and tumor states. Median follow-up period was 62 months. The TS group included more women, non-smokers or light smokers, and healthy patients. In the TS group, the disease states were significantly less aggressive. The TS group had a much better 5-year overall survival (OS) rate and cancer specific survival (CSS) rate than the TH group (p <0.0001, p <0.0001). Using propensity score matching, we extracted 190 patients each from the two groups. No statistical differences were present in the OS and CSS rates of the two matched groups (p =0.2223, p=0.0736), indicating the achievement of adequate balance. For a balanced cohort, intraoperative blood loss was significantly less (44 ± 40ml vs. 100 ± 78ml, p <0.0001), and the duration of postoperative drainage was shorter (2.1 ± 1.7 days vs. 3.5 ± 2.9 days, p <0.0001) in the TS group.View Large Image Figure ViewerDownload Hi-res image Download (PPT) We reported the excellent long-term oncological outcomes in patients with early-stage NSCLC after TS lobectomy. Although this is a single institutional, retrospective study, we successfully avoided selection bias in the patients and showed comparable treatment outcomes with lower invasiveness of TS as compared to that of TH.