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Video-assisted thoracic surgery versus open thoracotomy for non-small-cell lung cancer: a propensity score analysis based on a multi-institutional registry

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单位: [1]Collaborat Res CORE Grp, Systemat Review Unit, Sydney, NSW, Australia [2]Sun Yat Sen Univ, Ctr Canc, Dept Thorac Oncol, Guangzhou 510275, Guangdong, Peoples R China [3]Univ Sydney, Sydney, NSW 2006, Australia [4]Fudan Univ, Shanghai Zhongshan Hosp, Dept Thorac Surg, Shanghai 200433, Peoples R China [5]Tongji Univ, Shanghai Pulm Hosp, Dept Thorac Surg, Shanghai 200092, Peoples R China [6]Sichuan Univ, West China Hosp, Dept Cardiovasc & Thorac Surg, Chengdu 610064, Peoples R China [7]China & Japan Friendship Hosp, Dept Thorac Surg, Beijing, Peoples R China [8]Shenzhen Peoples Hosp, Dept Thorac Surg, Shenzhen, Peoples R China [9]Guangzhou Med Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Guangzhou 510120, Guangdong, Peoples R China [10]Guangzhou Inst Resp Dis, China State Key Lab Resp Dis, Guangzhou, Guangdong, Peoples R China [11]Guangzhou Med Univ, Sch Publ Hlth, Dept Stat, Guangzhou 510120, Guangdong, Peoples R China
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关键词: Video-assisted thoracic surgery Thoracotomy Non-small-cell lung cancer Propensity score analysis

摘要:
Comparative long-term survival and oncological outcomes for patients with non-small-cell lung cancer (NSCLC) who undergo video-assisted thoracic surgery (VATS) or conventional open lobectomy remain uncertain. We conducted a multi-institutional propensity-matched study to stratify potential differences in these outcomes. We established a multi-institutional registry for 4312 patients with NSCLC who underwent lobectomy between 2001 and 2008 from eight institutions in the People's Republic of China. Age, gender, histological type and tumour staging were entered into a non-parsimonious multivariable logistic regression model to assess long-term survival outcomes. The predicted probability derived from the logistic equation was used as the propensity score for each individual. Based on similar propensity scores, we matched 1458 of the 1700 patients who underwent VATS lobectomy with 1458 of the 2612 patients who underwent open lobectomy and compared their long-term survival outcomes. The mean age of the 2916 matched patients was 59 (standard deviation = 11) years. After propensity-matching, VATS and open lobectomy patients were similar in regards to important prognostic variables. Three prognostic factors were independently associated with improved survival in the multivariate analysis: age < 60 (P < 0.001), female gender (P = 0.013) and pathological staging (P < 0.001). Patients who underwent VATS vs open lobectomy had similar long-term survival (P = 0.07). The current propensity score analysis suggests that well-matched patients with NSCLC who underwent standardized VATS lobectomy had similar long-term survival outcomes when compared with those who underwent open lobectomy.

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出版当年[2012]版:
大类 | 3 区 医学
小类 | 3 区 呼吸系统 3 区 外科 4 区 心脏和心血管系统
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 外科 3 区 心脏和心血管系统 3 区 呼吸系统
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出版当年[2011]版:
Q1 SURGERY Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Q2 RESPIRATORY SYSTEM
最新[2023]版:
Q1 SURGERY Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Q2 RESPIRATORY SYSTEM

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2011版] 出版当年五年平均[2007-2011] 出版前一年[2010版] 出版后一年[2012版]

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第一作者单位: [1]Collaborat Res CORE Grp, Systemat Review Unit, Sydney, NSW, Australia
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通讯机构: [9]Guangzhou Med Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Guangzhou 510120, Guangdong, Peoples R China [10]Guangzhou Inst Resp Dis, China State Key Lab Resp Dis, Guangzhou, Guangdong, Peoples R China [*1]Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University Guangzhou Research Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease. No. 151, Yanjiang Rd, Guangzhou 510120, PR China
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