Comparison of clinical outcomes for patients with clinical N0 and pathologic N2 non-small cell lung cancer after thoracoscopic lobectomy and open lobectomy: a retrospective analysis of 76 patients.

OBJECTIVE: To compare outcomes between thoracoscopic and thoracotomy lobectomy for patients with cN0-pN2 NSCLC.

METHODS: One hundred eighty-two cN0 patients (including 29 pN2) underwent VATS lobectomy between September 2006 and December 2009, and 204 cN0 patients (including 47 pN2) underwent thoracotomy lobectomy between July 2000 and December 2009. Pre- and intraoperative status and postoperative survival between two groups were compared.

RESULTS: There was no difference in preoperative conditions between two groups except Quantity of smoking. Operation time and blood loss of VATS group was significantly lower than thoracotomy group. Number of dissected lymph node (LN) stations was 3.3 ± 1.1 in VATS group versus 3.3 ± 1.3 in thoracotomy group, and the total number of LN was 12.7 ± 8.9 in VATS group versus 10.5 ± 7.2 in thoracotomy group. One- and 3-year disease-free survival rate was 82.6% in VATS group versus 72.0% in thoracotomy group, and 49.3% in VATS group versus 51.3% in thoracotomy group (P=0.996). One- and 3-year survival rate was 84.9% in VATS group versus 71.2% in thoracotomy group, and 64.0% in VATS group versus 42.7% in thoracotomy group (P=0.121).

CONCLUSIONS: VATS lobectomy is comparable with thoracotomy in both safety and curability for the treatment of cN0-pN2 NSCLC, without necessity of conversion to open surgery.