Intraoperative Conversion During Video-assisted Thoracoscopy Resection for Lung Cancer Does Not Alter Survival

Study Overview
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Brief Summary
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Anatomical resection with systematic lymph-node dissection is currently the standard of care for the treatment of early stage non-small cell lung cancer. The use of minimally invasive approaches has increased greatly over the last two decades [either video-assisted thoracoscopic surgery (VATS) or robotic-assisted thoracoscopic surgery (RATS)], as they provide the patient with better outcomes than open thoracotomy. Minimally invasive VATS lobectomy for a standard case is generally a straightforward procedure for a well-trained surgical team, although concomitant preoperative pathologies or intraoperative findings/adverse events may result in technical difficulties, leading to intraoperative conversion, commonly by thoracotomy. The investigators aimed to assess long-term outcomes in a consecutive cohort of patients treated by anatomical pulmonary resection either using VATS, VATS requiring intraoperative conversion to thoracotomy, or upfront open thoracotomy for lung-cancer surgery.

Official Title
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Intraoperative Conversion During Video-assisted Thoracoscopy Resection for Lung Cancer Does Not Alter Survival

Conditions
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Video-assisted Thoracoscopic Surgery, Lung Cancer, Lobectomy, Survival, Surgery

Intervention / Treatment
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* Procedure: anatomical resection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All consecutive patients treated by anatomical lobar pulmonary resection (lobectomy, bilobectomy) or anatomical sublobar pulmonary resection (segmentectomy) for non-small cell lung cancer (NSCLC), either by VATS (eventually with intraoperative conversion) or upfront thoracotomy. Exclusion Criteria: patients with non-anatomical pulmonary resection (wedge resection) patients with a histology other than NSCLC (benign or metastatic from another primitive cancer), stage IV NSCLC disease, patients with multiple primary NSCLC (synchronous or metachronous) patients with incomplete resection (R+) patient for whom a VATS approach was never considered

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Full VATS<br> | Procedure: anatomical resection<br>* Anatomical resection with systematic lymph-node dissection<br>|
| VATS with conversion<br> | Procedure: anatomical resection<br>* Anatomical resection with systematic lymph-node dissection<br>|
| Thoracotomy upfront<br> | Procedure: anatomical resection<br>* Anatomical resection with systematic lymph-node dissection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall survival during the follow-up period after surgery |  | from day of surgery up to 7 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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video-assisted thoracoscopic surgery, lung-cancer surgery, intraoperative conversion to open surgery, lobectomy, survival