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Feasibility and surgical outcomes of video-assisted thoracoscopic pulmonary resection in patients with advanced-stage lung cancer after neoadjuvant chemoradiotherapy

 Jee Won Suh  ;  Seong Yong Park  ;  Chang Young Lee  ;  Jin Gu Lee  ;  Dae Joon Kim  ;  Hyo Chae Paik  ;  Kyoung Young Chung 
 THORACIC CANCER, Vol.10(5) : 1241-1247, 2019 
Journal Title
Issue Date
Chemoradiotherapy ; lung neoplasm ; neoadjuvant therapy ; thoracotomy ; video-assisted
Video-assisted thoracoscopic surgery (VATS) is regarded as the standard treatment for lung cancer. However, the feasibility and safety of VATS for lung cancer after neoadjuvant chemoradiotherapy (CRT) is unclear. This study evaluated the feasibility and safety of VATS in patients who had received neoadjuvant CRT. METHODS: Between January 2008 and December 2017, 85 patients who were administered neoadjuvant CRT and underwent anatomic lung resection were enrolled. Fifty-nine patients underwent open thoracotomy and 26 patients underwent VATS. The clinical characteristics and perioperative outcomes were reviewed. RESULTS: In six of the initial 32 patients who underwent VATS, the procedure was converted to thoracotomy. Adjacent structural invasion (33.9% vs. 11.5%; P = 0.037) and combined resection (16.9% vs. 0%; P = 0.025) were higher in the open group than in the VATS group. Surgical duration was higher in the open group than in the VATS group (203.86 ± 65.97 vs. 173.27 ± 59.87 minutes; P = 0.046). With regard to postoperative outcomes, the length of the hospital stay was longer in the open group compared to the VATS group (14.46 ± 16.94 vs. 8.62 ± 4.72 days; P = 0.017). There was no significant difference in the three-year disease-free survival (69.3% vs. 67.9%; P = 0.879) or overall survival rates (76.6% vs. 61.9%; P = 0.516). CONCLUSION: In selected patients, VATS pulmonary resection after neoadjuvant CRT showed results comparable to that of thoracotomy in terms of postoperative outcomes, operative morbidities, and survival rate.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Park, Seong Yong(박성용) ORCID logo https://orcid.org/0000-0002-5180-3853
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Suh, Jee Won(서지원) ORCID logo https://orcid.org/0000-0003-0287-0651
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Chung, Kyung Young(정경영)
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