Robotic Lobectomy After Induction Therapy for Locally Advanced Non-Small Cell Lung Cancer: A Multicenter Propensity Score-Matched study
Presented During:
Sunday, May 4, 2025: 9:00AM - 4:00PM
Seattle Convention Center | Summit
Posted Room Name:
Poster Area, Exhibit Hall
Abstract No:
P0192
Submission Type:
Abstract Submission
Authors:
Domenico Galetta (1), Lorenzo Spaggiari (2)
Institutions:
(1) Division of Thoracic Surgery, San Giovanni Bosco Hospital, Turin, Italy, (2) European Institute of Oncology, Milan, Lombardia
Submitting Author:
Domenico Galetta
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Division of Thoracic Surgery, San Giovanni Bosco Hospital
Division of Thoracic Surgery, San Giovanni Bosco Hospital
Co-Author:
Lorenzo Spaggiari
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European Institute of Oncology
European Institute of Oncology
Presenting Author:
Domenico Galetta
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European Institute of Oncology
European Institute of Oncology
Abstract:
Objective
The role of robotic surgery in locally advanced non-small cell lung cancer (NSCLC) is controversial. We evaluated the safety and effectiveness of robotic lobectomy after induction therapy (IT) by analyzing surgical and long-term outcomes. We compared outcomes of patients who received IT followed by lobectomy, via robotic surgery or thoracotomy.
Methods
Patients with locally advanced NSCLC and treated with radical surgery after IT between December 2008 and May 2024 in two distinct hospital were identified. Surgical outcomes and long-term survival were assessed using univariate analysis, Kaplan-Meier and Cox proportional hazard analysis. Propensity score-matched comparisons was used to assess the potential impact of selection bias.
Results
We identified 348 patients who underwent lobectomy for NSCLC after IT in the study period. The primary data set analyzed included 198 patients (145 open and 54 robotic surgeries). Propensity score matching yielded 50 pairs of patients. There was no difference between the two matched groups in terms of age, sex, smoke status, pulmonary and cardiac co-morbidities, body mass index, laterality, ASA score, histology, and type of IT. There was a significant difference in the median operative time (145 minute for open vs 186 minutes for robotic, p=0.02), estimates blood loss (180 ml for open vs 80 for robotic, p=0.01), number of dissected lymph nodes (22 for open vs. 27 for robotic; p=0.02), and hospital stay (6.2 days vs 4.5 days). There was no difference in terms of morbidity and mortality between the two groups (p=0.37 and p=0.48, respectively). No difference was observed between the two cohorts, either in terms of recurrence-free survival (hazard ratio: 1.07; p=0.43) or overall survival (hazard ratio: 0.74; p = 0.37). 5-year disease-free interval and overall survival were 22.6% and 50.6%, respectively, in open group, and 23.4% and 51.1%, respectively, in robotic group.
Conclusions
Robotic lobectomy in patients treated with IT for locally advanced NSCLC is feasible and effective and does not appear to compromise oncologic outcomes.
The role of robotic surgery in locally advanced non-small cell lung cancer (NSCLC) is controversial. We evaluated the safety and effectiveness of robotic lobectomy after induction therapy (IT) by analyzing surgical and long-term outcomes. We compared outcomes of patients who received IT followed by lobectomy, via robotic surgery or thoracotomy.
Methods
Patients with locally advanced NSCLC and treated with radical surgery after IT between December 2008 and May 2024 in two distinct hospital were identified. Surgical outcomes and long-term survival were assessed using univariate analysis, Kaplan-Meier and Cox proportional hazard analysis. Propensity score-matched comparisons was used to assess the potential impact of selection bias.
Results
We identified 348 patients who underwent lobectomy for NSCLC after IT in the study period. The primary data set analyzed included 198 patients (145 open and 54 robotic surgeries). Propensity score matching yielded 50 pairs of patients. There was no difference between the two matched groups in terms of age, sex, smoke status, pulmonary and cardiac co-morbidities, body mass index, laterality, ASA score, histology, and type of IT. There was a significant difference in the median operative time (145 minute for open vs 186 minutes for robotic, p=0.02), estimates blood loss (180 ml for open vs 80 for robotic, p=0.01), number of dissected lymph nodes (22 for open vs. 27 for robotic; p=0.02), and hospital stay (6.2 days vs 4.5 days). There was no difference in terms of morbidity and mortality between the two groups (p=0.37 and p=0.48, respectively). No difference was observed between the two cohorts, either in terms of recurrence-free survival (hazard ratio: 1.07; p=0.43) or overall survival (hazard ratio: 0.74; p = 0.37). 5-year disease-free interval and overall survival were 22.6% and 50.6%, respectively, in open group, and 23.4% and 51.1%, respectively, in robotic group.
Conclusions
Robotic lobectomy in patients treated with IT for locally advanced NSCLC is feasible and effective and does not appear to compromise oncologic outcomes.
THORACIC:
Innovations: New devices or novel approaches, preclinical or clinical
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