title: VATS lobectomy has better perioperative outcomes than open lobectomy: CALGB 31001, an ancillary analysis of CALGB 140202 (Alliance).
abstract: BACKGROUND
  The short-term superiority of video-assisted thoracoscopic surgery lobectomy compared with open lobectomy for early-stage lung cancer has been suggested by single-institution studies. Lack of equipoise limits the feasibility of a randomized study to confirm this. The hypothesis of this study (CALGB 31001) was that VATS lobectomy results in shorter length of hospital stay and fewer complications compared with open lobectomy in stages I and II non-small cell lung cancer in a multi-institutional setting.
  
  
  METHODS
  Five hundred nineteen patients whose tumors had been collected as part of CALGB 140202 (lung cancer tissue bank) were eligible. Propensity-scoring using age, race, sex, performance status, comorbidities, histology, tumor stage, and size as independent variables was used to create a 1:1 matched group of 175 pairs of patients. McNemar's test for binary variables and Wilcoxon signed-rank test for continuous variables were used to assess differences in length of hospital stay, complications, and discharge dispositions between the groups. Comparison of disease-free and overall survival between the two approaches was done using the log-rank test. Probability values of less than 0.05 were considered significant.
  
  
  RESULTS
  The matched data on length of hospital stay, complications, and discharge dispositions significantly favored the video-assisted thoracoscopic surgery group. There was no statistically significant difference in survival between the two approaches.
  
  
  CONCLUSIONS
  This multi-institutional study supports the assertion that thoracoscopic lobectomy results in shorter hospital length of stay, fewer perioperative complications, and greater likelihood of independent home discharge compared with open lobectomy for early-stage lung cancer. Survival was comparable between the two groups.
authors.affiliation: Roswell Park Cancer Institute, State University of New York at Buffalo, Buffalo, New York. Electronic address: chumy.nwogu@roswellpark.org.
authors.forename: Chukwumere E
authors.initials: CE
authors.lastname: Nwogu
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Jonathan
authors.initials: J
authors.lastname: D'Cunha
authors.affiliation: Alliance Statistics and Data Center, Duke University Medical Center, Durham, North Carolina;
authors.forename: Herbert
authors.initials: H
authors.lastname: Pang
authors.affiliation: Alliance Statistics and Data Center, Duke University Medical Center, Durham, North Carolina;
authors.forename: Lin
authors.initials: L
authors.lastname: Gu
authors.affiliation: Alliance Statistics and Data Center, Duke University Medical Center, Durham, North Carolina;
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Wang
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts;
authors.forename: William G
authors.initials: WG
authors.lastname: Richards
authors.affiliation: State University of New York Upstate Medical Center, Syracuse, New York.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Veit
authors.affiliation: Roswell Park Cancer Institute, State University of New York at Buffalo, Buffalo, New York.
authors.forename: Todd L
authors.initials: TL
authors.lastname: Demmy
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts;
authors.forename: David J
authors.initials: DJ
authors.lastname: Sugarbaker
authors.affiliation: State University of New York Upstate Medical Center, Syracuse, New York.
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Kohman
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts;
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Swanson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D057216:Propensity Score; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome