Video-assisted thoracoscopic surgery versus open lobectomy for resectable small cell lung cancer: A propensity score-matched cohort study

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Background While video-assisted thoracoscopic surgery (VATS) has emerged as the standard surgical approach for non-small cell lung cancer, its role in managing resectable small cell lung cancer (SCLC) remains controversial. Methods We conducted a retrospective analysis of patients with SCLC undergoing lobectomy at our institution between November 2005 and November 2021. Prospectively maintained clinical data were analyzed using 1:1 propensity score matching to balance baseline characteristics. Survival outcomes were evaluated through Kaplan–Meier estimates and multivariable Cox regression analyses. Results Among 178 eligible patients (VATS: 93, open: 85), 43 matched pairs demonstrated effective covariate balance. VATS was associated with significantly reduced intraoperative blood loss (66.97 ± 32.74 mL vs. 158.48 ± 158.25 mL, P = 0.002) and higher lymph node station yield (6.00 ± 1.72 vs. 5.07 ± 2.16, P = 0.035). The median follow-up time was 51.9 months. Survival analysis revealed no statistically significant differences in overall survival (hazards ratio [HR], 0.916, 95 % confidence interval [CI], 0.492–1.707; P = 0.783) and disease-free survival (HR, 0.836, 95 % CI, 0.460–1.519; P = 0.556) between the VATS and open lobectomy groups. Subgroup analysis suggested a non-significant trend toward improved overall survival with VATS compared to open lobectomy in patients with pT1-stage SCLC (HR, 0.292, 95 % CI, 0.061–1.387; P = 0.122). Conclusions Compared to open lobectomy, VATS demonstrated superior perioperative outcomes and achieved comparable long-term oncological outcomes in patients with resectable limited-stage SCLC. Prospective multi-center studies with larger cohorts are warranted to validate these findings.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.