Long-term results of robotic anatomical segmentectomy for early-stage non-small-cell lung cancer

Duy Nguyen, Farid - Gharagozloo, Barbara Tempesta, Mark Meyer, Angelika C Gruessner

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Anatomical segmentectomy is advocated for curative resection in select patients. We investigated the long-term results of robotic anatomical segmentectomy with mediastinal nodal dissection in patients with early-stage lung cancer. METHODS: We retrospectively reviewed patients who underwent robotic anatomical segmentectomy for early-stage non-small-cell lung cancer (NSCLC). The follow-up data were obtained to determine survival and statistically significant risk factors in both univariable and multivariable models. RESULTS: Seventy-one patients had clinical stage I NSCLC (36 men, 35 women, mean age 70 12 years). All patients underwent R0 resection. The mean operating time was 134 min. Ten of 71 (14%) patients were upstaged. Eight of 71 (11%) patients were upstaged due to the size of tumour in the pathological specimen, and 2 of 71 (3%) patients were upstaged due to microscopic N2 nodal metastasis. Median hospitalization was 4 days (2-31 days). Complication rate was 29%. There were no complications attributable to the surgical robot. No patient died within 90 days. Mean follow-up was 54 months (range 2 months to 9 years). The overall 5-year survival was 43%, whereas lung cancer-specific 5-year survival was 55%. The 5-year lung cancer-specific survival for pathological stage I disease was 73%. Local or mediastinal recurrence occurred in 4 of 71(5%) patients. Pathological upstaging or recurrence resulted in 0% 5-year survival. The univariable and multivariable analyses showed that advanced age and pathological upstaging were statistically significant risk factors for lung cancerspecific death. CONCLUSIONS: Robotic anatomical segmentectomy with mediastinal nodal dissection is a safe and feasible procedure. Accurate preoperative clinical staging is of critical importance for long-term survival.

Original languageEnglish (US)
Pages (from-to)427-433
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume55
Issue number3
DOIs
StatePublished - Mar 1 2019
Externally publishedYes

Fingerprint

Segmental Mastectomy
Robotics
Non-Small Cell Lung Carcinoma
Survival
Lung Neoplasms
Dissection
Recurrence
Hospitalization
Neoplasm Metastasis
Lung

Keywords

  • Early-stage lung cancer
  • Lung cancer
  • Mediastinal lymph nodes
  • Minimally invasive surgery
  • Robotic
  • Segmentectomy

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Long-term results of robotic anatomical segmentectomy for early-stage non-small-cell lung cancer. / Nguyen, Duy; Gharagozloo, Farid -; Tempesta, Barbara; Meyer, Mark; Gruessner, Angelika C.

In: European Journal of Cardio-thoracic Surgery, Vol. 55, No. 3, 01.03.2019, p. 427-433.

Research output: Contribution to journalArticle

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title = "Long-term results of robotic anatomical segmentectomy for early-stage non-small-cell lung cancer",
abstract = "Anatomical segmentectomy is advocated for curative resection in select patients. We investigated the long-term results of robotic anatomical segmentectomy with mediastinal nodal dissection in patients with early-stage lung cancer. METHODS: We retrospectively reviewed patients who underwent robotic anatomical segmentectomy for early-stage non-small-cell lung cancer (NSCLC). The follow-up data were obtained to determine survival and statistically significant risk factors in both univariable and multivariable models. RESULTS: Seventy-one patients had clinical stage I NSCLC (36 men, 35 women, mean age 70 12 years). All patients underwent R0 resection. The mean operating time was 134 min. Ten of 71 (14{\%}) patients were upstaged. Eight of 71 (11{\%}) patients were upstaged due to the size of tumour in the pathological specimen, and 2 of 71 (3{\%}) patients were upstaged due to microscopic N2 nodal metastasis. Median hospitalization was 4 days (2-31 days). Complication rate was 29{\%}. There were no complications attributable to the surgical robot. No patient died within 90 days. Mean follow-up was 54 months (range 2 months to 9 years). The overall 5-year survival was 43{\%}, whereas lung cancer-specific 5-year survival was 55{\%}. The 5-year lung cancer-specific survival for pathological stage I disease was 73{\%}. Local or mediastinal recurrence occurred in 4 of 71(5{\%}) patients. Pathological upstaging or recurrence resulted in 0{\%} 5-year survival. The univariable and multivariable analyses showed that advanced age and pathological upstaging were statistically significant risk factors for lung cancerspecific death. CONCLUSIONS: Robotic anatomical segmentectomy with mediastinal nodal dissection is a safe and feasible procedure. Accurate preoperative clinical staging is of critical importance for long-term survival.",
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AB - Anatomical segmentectomy is advocated for curative resection in select patients. We investigated the long-term results of robotic anatomical segmentectomy with mediastinal nodal dissection in patients with early-stage lung cancer. METHODS: We retrospectively reviewed patients who underwent robotic anatomical segmentectomy for early-stage non-small-cell lung cancer (NSCLC). The follow-up data were obtained to determine survival and statistically significant risk factors in both univariable and multivariable models. RESULTS: Seventy-one patients had clinical stage I NSCLC (36 men, 35 women, mean age 70 12 years). All patients underwent R0 resection. The mean operating time was 134 min. Ten of 71 (14%) patients were upstaged. Eight of 71 (11%) patients were upstaged due to the size of tumour in the pathological specimen, and 2 of 71 (3%) patients were upstaged due to microscopic N2 nodal metastasis. Median hospitalization was 4 days (2-31 days). Complication rate was 29%. There were no complications attributable to the surgical robot. No patient died within 90 days. Mean follow-up was 54 months (range 2 months to 9 years). The overall 5-year survival was 43%, whereas lung cancer-specific 5-year survival was 55%. The 5-year lung cancer-specific survival for pathological stage I disease was 73%. Local or mediastinal recurrence occurred in 4 of 71(5%) patients. Pathological upstaging or recurrence resulted in 0% 5-year survival. The univariable and multivariable analyses showed that advanced age and pathological upstaging were statistically significant risk factors for lung cancerspecific death. CONCLUSIONS: Robotic anatomical segmentectomy with mediastinal nodal dissection is a safe and feasible procedure. Accurate preoperative clinical staging is of critical importance for long-term survival.

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