Video-assisted thoracoscopic surgery versus open thoracotomy for resection of lung metastasis-A meta-analysis of reconstructed time-to-event data.

Publisher: Wiley Publishing Asia Pty Ltd Country of Publication: Singapore NLM ID: 101531441 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1759-7714 (Electronic) Linking ISSN: 17597706 NLM ISO Abbreviation: Thorac Cancer Subsets: MEDLINE

Publication: November 2012- : Singapore : Tianjin : Wiley Publishing Asia Pty Ltd ; Tianjin Lung Cancer Institute
Original Publication: Richmond, Vic. : Tianjin : Blackwell Pub. Asia Pty Ltd. ; Tianjin Lung Cancer Institute

Lung Neoplasms*/mortality ; Lung Neoplasms*/secondary ; Lung Neoplasms*/surgery ; Thoracic Surgery, Video-Assisted*/methods ; Thoracotomy*/methods; Humans ; Metastasectomy/methods ; Pneumonectomy/methods

This study aimed to conduct a systematic review and meta-analysis comparing video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT) in the context of pulmonary metastasectomy. Three databases were assessed. The primary outcome was overall survival. The secondary outcomes were recurrence-free survival, ipsilateral recurrence, and hospital length of stay (LOS). Hazard ratios (HRs), odds ratios (ORs), and mean difference (MD) with 95% confidence intervals (CIs) were calculated. Reconstruction of time-to-event data and sensitivity analyses were performed for the primary endpoint. After screening, 11 studies were included encompassing 2159 patients undergoing lung metastasectomy (VATS: 827; OT: 1332). Compared to OT, patients who underwent VATS had higher overall survival rates (HR 0.75; 95% CI 0.67-0.85; p < 0.01), no significant difference in recurrence-free survival (HR 1.07; 95% CI 0.88-1.29; p = 0.48), shorter hospital LOS (MD -1.99 days; 95% CI -2.59 to -1.39; p < 0.01), and no significant difference in ipsilateral recurrence rates (OR 0.86; 95% CI 0.52-1.42; p = 0.56). For patients undergoing pulmonary metastasectomy, VATS strategy is associated with higher survival rates and reduced hospital LOS when compared with OT. Moreover, metastasis recurrence does not seem to be associated with long-term mortality in this population.
(© 2024 The Author(s). Thoracic Cancer published by John Wiley & Sons Australia, Ltd.)

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413668513 Deutsche Forschungsgemeinschaft; S/03/23 Deutsche Herzstiftung

Keywords: lung metastasectomy; lung metastases; open thoracotomy; video‐assisted thoracoscopic surgery

Date Created: 20241018 Date Completed: 20241202 Latest Revision: 20241211

20250114

PMC11609047

10.1111/1759-7714.15473

39420460