ISMICS 2023 Annual Meeting

Introduction

•In traditional survival (TS) analyses, minimally invasive (MIS) lobectomy has been shown to be non-inferior to open lobectomy in the surgical management of non-small cell lung carcinoma (NSCLC)

•The conditional survival (CS) of NSCLC patients treated with MIS lobectomy remains unexplored, offering an opportunity to understand oncologic differences between these approaches

AIM

To evaluate traditional survival and conditional survival in a large cohort of patients with early-stage NSCLC managed with MIS lobectomy

Methods

•Review of the National Cancer Database (NCDB) from 2004-2019

•Identified patients with stage IA1/IA2 NSCLC who underwent upfront lobectomy

•Stratified patients via operative approach (MIS or thoracotomy)

•Multivariable TS and CS (assessed yearly up to 5 years post resection) analysis performed

•CS defined by: CS(x│y)=(S(y+x))/(S(y))

Results

•23,570 patients met inclusion criteria (Table)

•12,252 (52.0%) underwent MIS

•11,318 (48.0%) underwent thoracotomy

•TS confirmed survival benefit for MIS (hazard ratio [HR]: 0.91, p=0.002). CS showed survival benefit 1 and 2 years post resection (HR: 0.93, p=0.044 and HR: 0.91, p=0.014, respectively), but equivalence 3, 4, and 5 years following resection (p=0.107, p= 0.315, p=0.832, respectively; Figure)

CONCLUSIONS

•MIS showed survival benefits in TS and the 1 and 2 year CS, suggesting MIS confers a survival advantage over thoracotomy acutely following resection

•However, MIS is not statistically different in the 3, 4, and 5 year CS, suggesting the oncologic survival is similar between the approaches

ISMICS 2023 Annual Meeting

Evaluating The Conditional Survival Benefit Of Minimally Invasive Lobectomy In Early-stage Non-small Cell Lung Cancer

Poster Presenter

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