500 CONSECUTIVE ROBOTIC LOBECTOMIES FOR LUNG CANCER: PERIOPERATIVE AND ONCOLOGIC OUTCOMES
Luis J. Herrera1, Olivia Moreno, MD1, Eric M. Wherley1, Liqiang Ni, PhD2, Kojo Agyabeng-Dadzie1, Matthew Johnston, MD1, Juan Escalon, MD1.
1Orlando Health, Orlando, FL, USA, 2University of Central Florida, Orlando, FL, USA.
Clinical adoption of robotic lobectomy is increasing, but there is limited data regarding oncologic outcomes, particularly in advanced disease. We report perioperative and oncologic outcomes in our single institution experience with 500 consecutive robotic lobectomies, including a significant portion for locally advanced disease.
This study is a retrospective review of prospectively collected data from our Society of Thoracic Surgeons database and cancer registry records of 500 robotic lobectomies for lung cancer from 2010 to 2018. Segmentectomies and pneumonectomies were excluded as well as lobectomies performed for nonmalignant conditions. Loco-regional recurrence was defined as recurrence within the ipsilateral chest or mediastinal nodes. Survival analysis was performed using the Kaplan Meier method.
The mean patient age was 67(38-89) and 58.8% were females. Pathologic stage distribution was: IA 190(38%), IB 93(19%), IIA 87(17%), IIB 44(9%), IIIA 77(15%), IIIB 1(0.2%) and IV 8(2%). Elective conversion occurred in 26 cases(5.2%), and emergent conversion occurred in 3 cases(0.6%). Median length of stay was 3.0 days(1-40). The most common complications encountered were atrial fibrillation in 71(14.2%) and prolonged air leak in 49(9.8%). 30-day mortality occurred in 3 patients(0.6%). With a mean follow up of 28 months, loco-regional recurrence occurred in 34 patients(7.4 %) and overall 5-year survival was 64%(CI 59-76) for all patients and 82% for pathologic stage IA patient.
Robotic lobectomy for lung cancer is a safe feasible technique with low perioperative morbidity and mortality. Furthermore, excellent oncologic outcomes can be achieved with this approach, including in locally advanced disease.
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