Long-term patient outcome 10 years after video-assisted thoracoscopic surgery lobectomy for non-small-cell lung cancer

Introduction: Although there have been many reports associating video-assisted thoracoscopic surgery (VATS) with improved survival rates in early lung cancer, almost all of the reports have involved short median follow-ups and been presented at a 5-year point. Here, we establish the pattern and frequency of recurrences, as well as the long-term survival rates of patients who have undergone VATS more than 10 years ago. Methods: We retrospectively studied 41 patients who underwent VATS lobectomy for clinical stage I non-small-cell lung cancer at Fukuoka University Hospital between November 1994 and December 1999. All patients underwent lobectomy, including a dissection of hilar and mediastinal lymph nodes. Follow-up consisted of clinical and radiological examinations every 3 months for the first 2 years after the surgery and then once a year thereafter. Results: Of the 41 patients, 31 were diagnosed to be at pathologic stage IA and six at stage IB, while the remaining four were more advanced cases. During the follow-up period, recurrences were found in five cases (12.2%). Four patients with recurrence died of lung cancer and an additional two died from cancers of other organs. There were other non-cancer related deaths, largely from respiratory failures. Overall, the 5-and 10-year survival rates after the operation were 79.8% and 68.8%, respectively. Conclusion: Long-term survival and recurrence rates after a classic VATS lobectomy for lung cancer are favorable compared to the conventional approach.