Video-Assisted Thoracoscopic Surgery vs Thoracotomy for Non-Small Cell Lung Cancer Greater Than 5 cm: Is VATS a feasible approach for large tumors?

Background: VATS lobectomy is a recommended surgical approach for patients with early-stage lung cancer. However, it is still controversial in locally advance disease. This study was conducted to compare intraoperative and postoperative results of VATS and thoracotomy in patients with tumors greater than 5 cm.

Methods: From January 2014 to December 2018, 849 patients underwent lobectomy or pneumonectomy for the treatment of non-small-cell lung cancer at our center. The inclusion criterion of this study was patients who underwent anatomic lung resection for lung cancer with tumors larger than 5 cm((≥ T3). The patients were divided into two groups: those who underwent video-assisted thoracoscopic surgery (n = 24) and those who underwent thoracotomy (n = 36). Patient characteristics, intraoperative and postoperative results were evaluated by review of the hospital records.

Results: In the VATS group, mean drainage time and postoperative length of hospital stay were significantly shorter than the thoracotomy group. Kaplan-Meier survival curves showed that overall and recurrence-free survival was longer in the VATS group and this result was statistically significant.

Conclusions: According to the results of this study, we emphasize that VATS is a feasible surgical procedure for tumors larger than 5 cm.