title: Thoracoscopic Lobectomy Produces Long-Term Survival Similar to That with Open Lobectomy in Cases of Non-Small Cell Lung Carcinoma: A Propensity-Matched Analysis Using a Population-Based Cancer Registry.
abstract: There is a lack of large, prospective, randomized studies comparing thoracoscopic and open lobectomy in terms of long-term survival in the setting of NSCLC. Additionally, large case series evaluating the issue are limited. Until now, whether thoracoscopic lobectomy entails a long-term survival benefit compared with open lobectomy not been determined.
  
  
  
  Data were obtained from the National Health Insurance Research Database published in Taiwan. We included patients treated with open lobectomy or thoracoscopic lobectomy. In this retrospective review, the clinicopathologic characteristics of 5222 patients with lung cancer during the period 2004-2010 were analyzed. Patients were stratified according to clinical stage. Overall survival (OS) was compared between patients treated with open and those treated with thoracoscopic lobectomy and was also compared between patients in the three different clinical stages. Propensity-matching analysis and multivariate analysis were performed.
  
  
  
  Open lobectomy was performed on 3058 patients (58.6%) and thoracoscopic lobectomy on 2164 (41.4%). Propensity matching produced 1848 patients in each group. The 1-year, 3-year, and 5-year OS rates for propensity-matched patients treated with open lobectomy were 93.4%, 79.3%, and 65.5%, respectively. The 1-year, 3-year, and 5-year OS rates for propensity-matched patients treated with thoracoscopic lobectomy were 94.1%, 80.9%, and 68.7%, respectively. The difference was not statistically significant. In multivariate analysis, surgical resection (open versus thoracoscopic) was not an independent prognostic factor.
  
  
  
  This propensity-matched study suggests that open and thoracoscopic lobectomy are associated with similar long-term survival in the setting of lung cancer. Thoracoscopic lobectomy is an acceptable surgical treatment of lung cancer.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Republic of China; Chung Shan Medical University, Taichung, Republic of China; School of Medicine, Kaohsiung Medical University, Kaohsiung, Republic of China; Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Republic of China.
authors.forename: Bing-Yen
authors.initials: BY
authors.lastname: Wang
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Republic of China.
authors.forename: Jing-Yang
authors.initials: JY
authors.lastname: Huang
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Republic of China; Chung Shan Medical University, Taichung, Republic of China; Department of respiratory care, College of health sciences, Chang Jung Christian University, Tainan, Republic of China.
authors.forename: Ching-Hsiung
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Republic of China.
authors.forename: Jiunn-Liang
authors.initials: JL
authors.lastname: Ko
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Republic of China; Department of Radiology, Chang-Hua Christian Hospital, Changhua City, Republic of China.
authors.forename: Chen-Te
authors.initials: CT
authors.lastname: Chou
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Republic of China; School of Medicine, National Yang-Ming University, Taipei, Republic of China.
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Republic of China; Chung Shan Medical University, Taichung, Republic of China; Department of respiratory care, College of health sciences, Chang Jung Christian University, Tainan, Republic of China.
authors.forename: Sheng-Hao
authors.initials: SH
authors.lastname: Lin
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Republic of China; Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Republic of China. Electronic address: 156283@cch.org.tw.
authors.forename: Yung-Po
authors.initials: YP
authors.lastname: Liaw
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods*; D012042:Registries; D012189:Retrospective Studies; D013906:Thoracoscopy
keywords: Lobectomy; Lung cancer; Population; Thoracoscopic