title: [Long term outcomes of patients with stage I lung cancer treated by single-direction video-assisted thoracoscopic surgery lobectomy or segmentectomy].
abstract: OBJECTIVE
  To observe the outcome of stage I lung cancer treated by single-direction video-assisted thoracoscopic surgery (SD-VATS) major lung resection.
  
  
  METHODS
  Between May 2006 and December 2013, a total of 3 743 patients with lung cancer underwent surgical treatment in Department of Thoracic Surgery, West China Hospital. The clinical date of 783 patients with stage I lung cancer treated by SD-VATS lobectomy/segmentectomy was analyzed retrospectively. There were 388 males and 395 females with a mean age of (59 ± 10) years (range 25 to 86 years). There were 740 cases of lobectomy and 43 cases of segmentectomy. Twenty patients underwent conversion to open thoracotomy. The methods of Kaplan-Meier survival analysis and Cox proportional hazard regression model were used to investigate the long term outcome and prognostic factors.
  
  
  RESULTS
  The mean operating time was (145 ± 54) minutes (range 70 to 460 minutes). The median intraoperative blood loss was 50 (70) ml (range 5 to 1 200 ml). The postoperative morbidity and 90-day mortality were 13.3% and 1.0%, respectively. 5.9% patients were lost to follow-up. Finally 730 patients were enrolled into prognostic analysis with a mean follow-up time of (37 ± 18) months (range 5 to 92 months). The 5-year overall survival (OS), disease free survival (DFS), and cancer specific survival (CSS) were 83.8%, 74.4%, and 86.6%, respectively. The 5-year OS of IA and IB were 90.7% and 79.8% respectively. Univariate and multivariate analysis indicated that age ≥ 60 years (OR = 1.786, 95% CI: 1.081 to 2.948, P = 0.023), non-adenocarcinoma (OR = 1.647, 95% CI: 1.204 to 2.253, P = 0.002), and higher T status (OR = 2.709, 95% CI: 1.031 to 7.121, P = 0.043) were independently associated with poor OS; higher T status (OR = 5.118, 95% CI: 2.330 to 11.240, P = 0.000) and higher pathological stage status (OR = 0.369, 95% CI: 0.137 to 0.991, P = 0.048) were independently associated with poor DFS; non-adenocarcinoma (OR = 1.717, 95% CI: 1.224 to 2.409, P = 0.002) and higher T status (OR = 5.029, 95% CI: 1.432 to 17.659, P = 0.012) were independently associated with poor CSS.
  
  
  CONCLUSIONS
  SD-VATS lung cancer resection is a safe and feasible method for the treatment of stage I lung cancer resulting good outcomes.
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Chengwu
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Chenglin
authors.initials: C
authors.lastname: Guo
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Pu
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Mei
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Liao
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Yunke
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Teng
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Yongsheng
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Kejia
authors.initials: K
authors.lastname: Zhao
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Longfei
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Guowei
authors.initials: G
authors.lastname: Che
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Yidan
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Yingli
authors.initials: Y
authors.lastname: Kou
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China; Email: lunxu_liu@aliyun.com.
authors.forename: Lunxu
authors.initials: L
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D002681:China; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D011013:Pneumonectomy / Q000379:methods*; D011184:Postoperative Period; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy