Long-Term Oncological Outcomes of Minimally Invasive Surgery in Non-Small Cell Lung Cancer: An Updated Review

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonology

Background:

• Non-small cell lung cancer (NSCLC) is the most common type of lung cancer.
• Surgical resection is the standard treatment for resectable NSCLC.
• Minimally invasive surgery (MIS) aims to reduce morbidity while maintaining oncological outcomes.

Purpose of the Study:

• To review long-term oncological outcomes of MIS for NSCLC.
• To compare video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracoscopic surgery (RATS) with open surgery.
• To evaluate outcomes across different stages of NSCLC.

Main Methods:

• Narrative review of retrospective and prospective studies, and meta-analyses.
• Evaluation of overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS).
• Inclusion of studies on VATS and RATS for NSCLC resection.

Main Results:

• VATS shows comparable or superior oncological outcomes to open surgery, especially in early stages.
• RATS demonstrates comparable oncological outcomes to open surgery, even in advanced stages.
• VATS and RATS show similar OS; RATS may offer a DFS advantage.

Conclusions:

• MIS is a safe and effective approach for resectable NSCLC regarding oncological outcomes.
• Both VATS and RATS provide significant benefits for NSCLC patients.
• Ongoing randomized trials will further clarify the long-term advantages of VATS versus RATS.