Long term survival with thoracoscopic versus open lobectomy: propensity matched comparative analysis using SEER-Medicare database

• Autores: Paul Subroto, J Isaacs Abby, Tom Treasure, Nasser K. Altorki
• Localización: BMJ, ISSN-e 0959-535X, Vol. 349, Nº. 7977, 2014, pág. 5575
• Idioma: inglés
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• Resumen

  • Objective To compare long term survival after minimally invasive lobectomy and thoracotomy lobectomy.

    Design Propensity matched analysis.

    Setting Surveillance, Epidemiology and End Results (SEER)-Medicare database.

    Participants All patients with lung cancer from 2007 to 2009 undergoing lobectomy.

    Main outcome measure Influence of less invasive thoracoscopic surgery on overall survival, disease-free survival, and cancer specific survival.

    Results From 2007 to 2009, 6008 patients undergoing lobectomy were identified (n=4715 (78%) thoracotomy). The median age of the entire cohort was 74 (interquartile range 70-78) years. The median length of follow-up for entire group was 40 months. In a matched analysis of 1195 patients in each treatment category, no statistical differences in three year overall survival, disease-free survival, or cancer specific survival were found between the groups (overall survival: 70.6% v 68.1%, P=0.55; disease-free survival: 86.2% v 85.4%, P=0.46; cancer specific survival: 92% v 89.5%, P=0.05).

    Conclusion This propensity matched analysis showed that patients undergoing thoracoscopic lobectomy had similar overall, cancer specific, and disease-free survival compared with patients undergoing thoracotomy lobectomy. Thoracoscopic techniques do not seem to compromise these measures of outcome after lobectomy.