Comparative Analysis of Robotic Segmentectomy For Non-Small Cell Lung Cancer - A National Cancer Database Study
Syed S. Razi, Dao Nguyen, Nestor Villamizar.
University of Miami / Jackson Memorial Hospital, Miami, FL, USA.
ObjectiveThe use of segmentectomy for peripheral T1a-b, N0 non-small cell lung cancer (NSCLC) has increased in the last decade. Our objective was to evaluate clinical outcomes and overall survival after robotic segmentectomy compared to other standardized surgical approaches. MethodsThe National Cancer Database was queried for patients with clinical T1a-b, N0 NSCLC who underwent segmentectomy via robotic, thoracoscopic (VATS) and open approaches (2010 to 2015). Univariate analysis and Cox regression analysis were used to compare different surgical approaches and to evaluate predictors of overall survival. All statistical analysis was done using SPSS v 21.0. ResultsSegmentectomy was performed in 3,888 patients during the study period. The robotic approach was utilized in 406, VATS in 1,837 and open in 1,645 patients. Conversion to open thoracotomy was significantly higher for VATS (8.0%) as compared to robotic (4.9%), p = 0.036. Lymph nodes yield was significantly higher for robotic (mean = 7.07), compared to VATS (mean = 6.33) or open (mean = 5.23), p < 0.001. Lymph node upstaging was similar among robotic (3.0%), VATS (3.0%) and open (4.3%), p = 0.106. No differences between length of stay (p = 0.374) or 30-day readmissions (p = 0.116) were observed among different groups. Overall survival was also similar among different groups, p = 0.181, figure 1 & table 1. ConclusionsRobotic segmentectomy provides similar clinical outcomes compared to other standardized approaches, for cT1a-b, N0 NSCLC. A higher lymph node yield in robotic segmentectomy was not associated with improved survival in this study population.
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