Mortality for robotic- versus video-assisted lobectomy treated stage I non-small cell lung cancer patients

Menée aux Etats-Unis à partir de données du registre national des cancers portant sur 18 908 patients atteints d'un cancer du poumon non à petites cellules de stade I traité entre 2010 et 2014, cette étude compare, du point de vue de la mortalité, l'intérêt d'une lobectomie thoracoscopique vidéo-assistée et d'une lobectomie thoracoscopique assistée par robot

Résumé en anglais

Background : To address the United States Food & Drug Administration’s recent safety concern on robotic surgery procedures, we compared short- and long-term mortality for stage I non-small cell lung cancer (NSCLC) patients treated by robotic-assisted thoracoscopic surgical lobectomy (RATS-L) versus video-assisted thoracoscopic surgical lobectomy (VATS-L).

Methods : From the National Cancer Database, we identified 18,908 stage I NSCLC patients who underwent RATS-L or VATS-L as the primary operation from 2010 to 2014. Cox proportional hazards models were used to estimate hazard ratios (HRs) for short- and long-term mortality using unmatched and propensity score-matched analyses. All statistical tests were two-sided.

Results : Patients treated by RATS-L had higher 90-day mortality than those with VATS-L (6.6% vs. 3.8%; P=.03) if conversion to open thoracotomy occurred. After excluding first-year observation, multiple regression analyses showed RATS-L was associated with increased long-term mortality, compared to VATS-L, in cases with tumor size