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Outcomes of minimally invasive lung resection with concomitant chest wall resection in non-small cell lung cancer (NSCLC).

Journal of thoracic disease 2025 Vol.17(11) p. 10254-10261

Alaparthi SS, Ishwar A, Madeka I, Ho A, Grenda T, Evans NR, Okusanya OT

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[BACKGROUND] Traditionally, lung and chest wall (CW) resections were performed via an open approach for non-small cell lung cancer (NSCLC) with CW involvement.

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  • p-value P=0.002
  • p-value P<0.001
  • 연구 설계 cohort study

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BibTeX ↓ RIS ↓
APA Alaparthi SS, Ishwar A, et al. (2025). Outcomes of minimally invasive lung resection with concomitant chest wall resection in non-small cell lung cancer (NSCLC).. Journal of thoracic disease, 17(11), 10254-10261. https://doi.org/10.21037/jtd-2025-1577
MLA Alaparthi SS, et al.. "Outcomes of minimally invasive lung resection with concomitant chest wall resection in non-small cell lung cancer (NSCLC).." Journal of thoracic disease, vol. 17, no. 11, 2025, pp. 10254-10261.
PMID 41376902

Abstract

[BACKGROUND] Traditionally, lung and chest wall (CW) resections were performed via an open approach for non-small cell lung cancer (NSCLC) with CW involvement. Our objective is to examine the outcomes of patients with NSCLC and CW involvement resected through a minimally invasive (MIS) [video-assisted thoracoscopic surgery (VATS) or robotic] approach.

[METHODS] This is a retrospective cohort study of the 2021 National Cancer Database (NCDB). We examined patients >18 years who underwent MIS or open lung and CW resection for clinically N0M0 NSCLC between 2010 and 2020. Outcomes studied include 30-, 90-day mortality, and readmission. Additionally, the number of nodes examined, margins, and rate of nodal upstaging were analyzed.

[RESULTS] A total of 1,370 patients treated with an open resection and 352 patients treated with a MIS approach were examined. The average age at diagnosis was 66 years. The average primary tumor size was 4.75 cm (3.2-6.5 cm) in the MIS cohort and 5.7 cm (4.2-7.3 cm) in the open cohort. There was a significant difference in 30-day mortality between cohorts (P=0.002). There were no significant differences in other outcome measures (90-day mortality, readmission). There was no significant difference in margin positivity or nodal upstaging. There were more overall nodes examined in the MIS cohort (14 11, P<0.001). There were no significant differences in the 5-year overall survival (OS) between cohorts. Post-propensity score matching outcomes yielded similar significance to the unmatched cohort.

[CONCLUSIONS] This study suggests that MIS lung and CW resection is associated with similar short and long-term outcomes in most measures as compared to open surgery.

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