Early Outcomes After Robotic- Versus Video-Assisted Thoracic Surgery for Early-Stage Lung Cancer.

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Patient-Reported Outcomes

Background:

• Patient-reported outcomes (PROs) are crucial for evaluating surgical intervention effectiveness.
• Comparing multiportal robotic-assisted thoracic surgery (M-RATS) with multiportal video-assisted thoracic surgery (M-VATS) is important for early-stage lung cancer treatment.
• This study assesses early PROs and clinical outcomes between M-RATS and M-VATS for lobectomy or sublobar resection.

Purpose of the Study:

• To compare early patient-reported and clinical outcomes between M-RATS and M-VATS.
• To evaluate symptom burden and functional status post-surgery for early-stage lung cancer.
• To determine the sustainability of PRO advantages after discharge.

Main Methods:

• Longitudinal cohort study (CN-PRO-Lung 3) data utilized.
• Perioperative Symptom Assessment Scale for Lung Surgery assessed PROs.
• Generalized estimation equation models compared M-RATS and M-VATS outcomes.

Main Results:

• M-RATS group showed significantly fewer moderate-to-severe symptoms (36.8% vs. 46.5%) and functional deficits (38.5% vs. 49.2%) on postoperative days 1-4.
• No significant PRO differences observed between M-RATS and M-VATS from day 1 to 30 post-discharge.
• M-RATS associated with shorter operative time, less blood loss, more lymph nodes harvested, but higher cost.

Conclusions:

• M-RATS may offer reduced early postoperative symptom burden and improved functional status compared to M-VATS for early-stage lung cancer.
• The early PRO advantages of M-RATS may not be sustained beyond the immediate postoperative period.
• Clinical benefits like shorter operative time and less blood loss favor M-RATS, despite increased cost.