P3.16-37 Comparison of Long-Term Outcomes Between VATS and Open Lobectomies for Stage I NSCLC: Propensity Score-Matching Analysis

Abstract

Video-assisted thoracoscopic surgery (VATS) lobectomy is widely spread for patients with clinical stage I non-small cell lung cancer (NSCLC). The postoperative survival and safety of VATS lobectomy are reported equal or better than those of open lobectomy. We retrospectively reviewed the clinical data of 186 patients underwent lobectomy with clinical and pathological stage IA NSCLC from January 2008 to December 2013. Perioperative clinical factors and outcomes of patients with clinical and pathological stage IA NSCLC who underwent lobectomy were compared between VATS (n=63) and thoracotomy (n=123) using a propensity score-matching analysis. In the analysis of 61 matched cases, the VATS group showed decreased blood loss and lower value of the C-reactive protein (CRP) at the peak, despite longer operative time. The VATS group demonstrated a significant longer survival, despite greater number of preoperative comorbidities than the thoracotomy group. The 5-year overall survival (OS) of VATS and thoracotomy were 100% and 89% each (log-rank p=0.02). The 5-year disease-free survival (DFS) of VATS and thoracotomy were 100% and 81% in each (log-rank p<0.01). The results of this study indicate that VATS has some advantages compared with thoracotomy in early stage lung cancer patients.