Back to Thoracic Track Day Program
Robotic Segmentectomy and Mediastinal Nodal Dissection for Early-Stage Non-Small Cell Lung Cancer
D. Nguyen, B. Tempesta, A. Gruessner, B. Rawashdeh, M. Moslemi, M. Meyer, S. Golestani, R Poston, F. Gharagozloo
The University of Arizona Medical Center, Tucson, AZ, USA.
Background: Lobectomy is the gold standard for treating early-stage non-small cell lung cancer (NSCLC). Anatomic segmentectomy is advocated for curative resection in select patients. We investigated the safety and oncologic efficacy of robotic anatomic segmentectomy with mediastinal nodal dissection.
Methods: We retrospectively reviewed patients who underwent robotic anatomic segmentectomy for early-stage NSCLC. Robotic dissection of the main bronchovascular structures was followed by division of respective segmental structures and mediational nodal dissection. Follow-up data was obtained to determine survival, along with statistically significant risk factors in both univariate and multivariate models.
Results: 153 patients underwent robotic anatomic segmentectomy. 61 patients had clinical Stage I NSCLC (31 men, 30 women, mean age 70+/-12 years). All patients underwent R0 resection. Mean operating time was 134 minutes. 10/61 patients (16%) were upstaged. Median hospitalization was 7 days (2-31 days). Complication rate was 29%. There was no 30-day mortality. Mean follow-up was 30 months (range 2 months to 9 years). Overall 5-year survival was 43%, while lung cancer-specific 5-year survival was 55%. 5-year lung cancer-specific survival for pathologic stage I disease was 73%. Local or mediastinal recurrence occurred in 3/50 patients. Pathologic upstaging or recurrence resulted in 0% 5-year survival. Univariate and multivariate analysis showed that advanced age and pathologic upstaging were statistically significant risk factors for lung cancer-specific death.
Conclusion: Robotic segmentectomy with mediastinal nodal dissection is a safe and oncologically efficacious procedure. Accurate preoperative clinical staging is of critical importance in long term survival.
Back to Thoracic Track Day Program