Survival After Thoracoscopic Surgery or Open Lobectomy: Systematic Review and Meta-Analysis.
Journal
The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
04
03
2020
revised:
10
05
2020
accepted:
18
05
2020
pubmed:
31
7
2020
medline:
29
1
2021
entrez:
31
7
2020
Statut:
ppublish
Résumé
Video-assisted thoracoscopic surgery (VATS) has been shown to reduce hospital stays and pain compared with open lobectomy to treat non-small cell lung cancer. Because of the low rate of deaths, it is difficult to show differences in survival in individual studies. The objective of this study was to compare short- and long-term mortality by means of a systematic review and meta-analysis. The reviewers systematically searched studies that compared VATS vs open lobectomy and provided data on 30-day mortality or long-term survival (>5 years). For long-term outcomes, studies included patients with the same cancer stage or, if several stages were included, the studies had to control for cancer stage in their propensity score model. A pooled odds ratio and hazard ratio (HR) was respectively calculated for short- and long-term outcomes. A total of 33 works were identified, comprising 61,633 patients. VATS led to lower postoperative mortality (odds ratio, 0.64; 95% confidence interval [CI], 0.56 to 0.73) and higher long-term survival (HR, .88; 95% CI, 0.81 to 0.96). Disease-free survival was similar in both groups (HR, 0.94; 95% CI, 0.80 to 1.10). For non-small cell lung cancer treated with lobectomy, VATS was associated with lower postoperative mortality and greater long-term survival compared with open lobectomy. Disease-free survival was similar between both groups.
Sections du résumé
BACKGROUND
Video-assisted thoracoscopic surgery (VATS) has been shown to reduce hospital stays and pain compared with open lobectomy to treat non-small cell lung cancer. Because of the low rate of deaths, it is difficult to show differences in survival in individual studies. The objective of this study was to compare short- and long-term mortality by means of a systematic review and meta-analysis.
METHODS
The reviewers systematically searched studies that compared VATS vs open lobectomy and provided data on 30-day mortality or long-term survival (>5 years). For long-term outcomes, studies included patients with the same cancer stage or, if several stages were included, the studies had to control for cancer stage in their propensity score model. A pooled odds ratio and hazard ratio (HR) was respectively calculated for short- and long-term outcomes.
RESULTS
A total of 33 works were identified, comprising 61,633 patients. VATS led to lower postoperative mortality (odds ratio, 0.64; 95% confidence interval [CI], 0.56 to 0.73) and higher long-term survival (HR, .88; 95% CI, 0.81 to 0.96). Disease-free survival was similar in both groups (HR, 0.94; 95% CI, 0.80 to 1.10).
CONCLUSIONS
For non-small cell lung cancer treated with lobectomy, VATS was associated with lower postoperative mortality and greater long-term survival compared with open lobectomy. Disease-free survival was similar between both groups.
Identifiants
pubmed: 32730840
pii: S0003-4975(20)31200-5
doi: 10.1016/j.athoracsur.2020.05.144
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
302-313Informations de copyright
Copyright © 2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.