Equivalency of oncological outcomes during lobectomy by video-assisted thoracoscopic surgery versus thoracotomy

The aim of this study was to compare the results of oncological outcomes during lobectomy during video-assisted thoracoscopic surgery (VATS) versus thoracotomy for clinical stage I non-small cell lung cancer (NSCLC). We retrospectively reviewed clinical and follow-up data from 401 consecutive patients undergoing lobectomy for clinical stage I NSCLC by VATS or thoracotomy, between January 2008 and December 2013. In total, 401 lobectomies for clinical stage I NSCLC were performed, including 185 lobectomies by VATS and 216 lobectomies by thoracotomy. Patient demographic data, type of resection, histological type, and pathological data were comparable between the two groups. There was less blood loss (P < 0.05), less post-operative analgesia needed (P < 0.05), shorter duration of chest drainage (P < 0.05), and earlier hospital discharge (P < 0.05) in the VATS group than in the thoracotomy group (P < 0.05), although operative time was significant longer for VATS than for thoracotomy (P < 0.05). The entirety of lymphadenectomy was comparable between the two groups. Overall survival and recurrence-free survival were similar in both groups. The current results indicate that VATS lobectomy results in oncological outcomes that are equivalent to open surgery for clinical stage I NSCLC.