Short-term and long-term survival in sleeve lobectomy by video-assisted thoracic surgery versus thoracotomy basing on the propensity score matching

Abstract

Objective: To evaluate the safety and efficacy of patients with centrally located lung cancer in sleeve lobectomy by video-assisted thoracic surgery (VATS). Methods: A retrospective analysis was performed on consecutive patients with centrally located lung cancer who underwent sleeve lobectomy admitted in the Affiliated Hospital of Qingdao University from January 2010 to September 2014. Propensity score matching analysis was performed to compare patients for thoracoscopic surgery and open surgery. Twenty-one pairs (42 cases) patients were included for analysis. The t-test, χ(2) test or Fisher's exact probabilities was adopted, if appropriate, to compare demographics and outcomes between the 2 groups. The Kaplan-Meier method and the Log-rank test were used for the distributions of disease free survival (DFS) and overall survival (OS) and their comparisons. Results: After propensity score-matched analysis, the VATS group had a longer operative time ((296.9±73.6) minutes vs. (218.1±59.2) minutes, t=3.82, P=0.00), but shorter postoperative drainage time ((3.3±1.5) days vs. (2.0±3.0) days, t=-0.93, P=0.01) and hospitalization time((6.7±2.8) days vs. (12.1±8.7)days, t=-1.72, P=0.01) than that of the thoracotomy group. Perioperative complications, 1-year and 3-year disease-free and overall survival rates were not statistically different between the two groups. Conclusion: For suitable patients, sleeve lobectomy by VATS is an acceptable safe and effective surgical procedure for patients with central lung cancer.