Video-assisted thoracoscopic surgery versus open lobectomy for stage I lung cancer: A meta-analysis of long-term outcomes

Li,Zhengjun; Liu,Hongxu; Li,Le

doi:10.3892/etm.2012.485

Video-assisted thoracoscopic surgery versus open lobectomy for stage I lung cancer: A meta-analysis of long-term outcomes

Authors:
- Zhengjun Li
- Hongxu Liu
- Le Li
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Affiliations: Department of Thoracic Surgery, First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, P.R. China, Department of General Surgery, First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, P.R. China
Published online on: February 13, 2012 https://doi.org/10.3892/etm.2012.485
Pages: 886-892

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Abstract

The present study aimed to evaluate the evidence comparing video-assisted thoracoscopic surgery (VATS) and open lobectomy for the treatment of stage I lung cancer using meta-analytical techniques. A literature search was undertaken until July 2011 to identify comparative studies evaluating survival rates, recurrence rates and complications. Pooled odds ratios (OR) and 95% confidence intervals (95% CI) were calculated with either the fixed- or random-effects model. These studies included a total of 1,362 patients: 668 treated with VATS and 694 treated with open lobectomy. The overall survival was significantly higher in patients treated with VATS than with open thoracotomy (OR=2.01, 95% CI 1.44-2.78) at 5 years. However, there was no statistically significant difference in 1.3-year overall survival between the VATS and open lobectomy groups (OR=3.21, 95% CI 0.77-13.40; OR=0.91, 95% CI 0.49-1.70). The data did not demonstrate a significant difference in locoregional recurrence (OR=0.58, 95% CI 0.33‑1.03) compared to the open lobectomy group, but suggested a reduced systemic recurrence rate (OR=0.52, 95% CI 0.23-0.82) and complications (OR=0.36, 95% CI 0.23‑0.57) of VATS. VATS was superior to open lobectomy for the prognosis of stage I lung cancer. However, the findings have to be carefully interpreted due to the lower levels of evidence.

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