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Publication Detail
Long term survival with thoracoscopic versus open lobectomy: propensity matched comparative analysis using SEER-Medicare database.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Comparative Study
  • Authors:
    Paul S, Isaacs AJ, Treasure T, Altorki NK, Sedrakyan A
  • Publication date:
  • Pagination:
    g5575, ?
  • Journal:
  • Volume:
  • Status:
    Published online
  • Country:
  • Language:
  • Keywords:
    Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Databases, Factual, Disease-Free Survival, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Lung Neoplasms, Male, Medicare, Neoplasm Invasiveness, Neoplasm Staging, Pneumonectomy, Postoperative Complications, Proportional Hazards Models, Retrospective Studies, SEER Program, Survival Analysis, Thoracoscopy, Thoracotomy, Time Factors, Treatment Outcome, United States
OBJECTIVE: To compare long term survival after minimally invasive lobectomy and thoracotomy lobectomy. DESIGN: Propensity matched analysis. SETTING: Surveillance, Epidemiology and End Results (SEER)-Medicare database. PARTICIPANTS: All patients with lung cancer from 2007 to 2009 undergoing lobectomy. MAIN OUTCOME MEASURE: Influence of less invasive thoracoscopic surgery on overall survival, disease-free survival, and cancer specific survival. RESULTS: From 2007 to 2009, 6008 patients undergoing lobectomy were identified (n=4715 (78%) thoracotomy). The median age of the entire cohort was 74 (interquartile range 70-78) years. The median length of follow-up for entire group was 40 months. In a matched analysis of 1195 patients in each treatment category, no statistical differences in three year overall survival, disease-free survival, or cancer specific survival were found between the groups (overall survival: 70.6% v 68.1%, P=0.55; disease-free survival: 86.2% v 85.4%, P=0.46; cancer specific survival: 92% v 89.5%, P=0.05). CONCLUSION: This propensity matched analysis showed that patients undergoing thoracoscopic lobectomy had similar overall, cancer specific, and disease-free survival compared with patients undergoing thoracotomy lobectomy. Thoracoscopic techniques do not seem to compromise these measures of outcome after lobectomy.
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