title: Evaluation of video-assisted thoracoscopic surgery for pulmonary metastases: a meta-analysis.
abstract: BACKGROUND
  To evaluate the evidence comparing video-assisted thoracic surgery (VATS) and open thoracotomy in the treatment of metastatic lung cancer using meta-analytical techniques.
  
  
  METHODS
  A literature search was undertaken until July 2013 to identify the comparative studies evaluating disease-free survival rates and survival rates. The pooled odds ratios (OR) and the 95% confidence intervals (95% CI) were calculated with the fixed or random effect models.
  
  
  RESULTS
  Six retrospective studies were included in our meta-analysis. These studies included a total of 546 patients: 235 patients were treated with VATS, and 311 patients were treated with open thoracotomy. The VATS and the thoracotomy did not demonstrate a significant difference in the 1-,3-,5-year survival rates and the 1-year disease-free survival rate. There were significant statistical differences between the 3-year disease free survival rate (p = 0.04), which favored open thoracotomy.
  
  
  CONCLUSIONS
  The VATS approach is a safe and feasible treatment in terms of the survival rate for metastatic lung cancer compared with the thoracotomy. The 3-year disease-free survival rate in the VATS group is inferior to that of open thoracotomy. The VATS approach could not completely replace open thoracotomy.
authors.affiliation: Department of Thoracic Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
authors.forename: Siyuan
authors.initials: S
authors.lastname: Dong
authors.affiliation: Department of Thoracic Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
authors.forename: Wenya
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Thoracic Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Du
authors.affiliation: Department of Thoracic Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
authors.forename: Xiangli
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
authors.forename: Xitao
authors.initials: X
authors.lastname: Chen
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016017:Odds Ratio; D011013:Pneumonectomy; D012189:Retrospective Studies; D016019:Survival Analysis; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D016896:Treatment Outcome