Long-Term Oncologic Outcomes in Robot-Assisted and Video-Assisted Lobectomies for Non-Small Cell Lung Cancer.

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Non-small cell lung cancer (NSCLC) management often involves lobectomy.
• Video-assisted thoracic surgery (VATS) and robotic-assisted thoracic surgery (RATS) are minimally invasive approaches.
• Comparing long-term outcomes between VATS and RATS is crucial for treatment optimization.

Purpose of the Study:

• To compare the long-term efficacy of RATS versus VATS lobectomy for NSCLC.
• To evaluate differences in overall survival, disease-free survival, and recurrence rates.
• To assess secondary outcomes including complications and hospitalization duration.

Main Methods:

• A single-center prospective study included 619 patients (403 RATS, 216 VATS) undergoing lobectomy for NSCLC.
• Primary outcomes: overall survival (OS), disease-free survival (DFS), recurrence rate.
• Secondary outcomes: complication rate, length of hospitalization (LOS), duration of chest tubes (LOD), lymph node yield.

Main Results:

• No significant difference in OS between RATS and VATS.
• RATS demonstrated significantly higher DFS (3-year: 92.4% vs. 81.2%; 5-year: 90.3% vs. 77.6%; p < 0.001).
• RATS had a significantly lower recurrence rate (6.2% vs. 21.8%; p < 0.001) and higher lymph node yield (7 vs. 5 stations; p < 0.001).

Conclusions:

• RATS lobectomy for NSCLC is associated with significantly improved DFS and reduced recurrence rates compared to VATS.
• The enhanced nodal dissection in RATS may contribute to better long-term disease control.
• Hospitalization, complications, and mortality were similar between the two surgical approaches.