P192. Robotic Lobectomy After Induction Therapy for Locally Advanced Non-Small Cell Lung Cancer: A Multicenter Propensity Score-Matched study
European Institute of Oncology
Milano, Turin
Italy - Contact Me
Dr. Galetta was born in Italy in 1971.
He is actually Chief of the Division of Thoracic Surgery of San Giovanni Bosco Hospital Turin, Italy since May 2024.
He degreed as M.D. in 1996 at Catholic University in Rome and there he complete his residency in Thoracic Surgery in 2002.
Previous experiences included a period at the Thoracic, Cardiac and Transplantation Dpt. of University of Nantes, France in 1998 (Prof. J.L. Michaud), and from 2001 to 2003 at Dpt, of Thoracic Surgery of the Institute Mutualiste Montsouris, Paris, France (Prof. D. Grunenwald).
He was degreed with the Diplome Inter-Universitaire de Chirurgie Thoracoscopique et Pneumologie Interventionnelle, Université René Descartes-Paris V,Paris, France in 2002.
Dr. Galetta has become Ph.D.in 2009 at the University of Bologna, Italy.
He worked as Senior Deputy Director at the Division of Thoracic Surgery at European Institut oof Oncology, Milan, Italy form May 204 to May 2024.
He was Assistant Professor at the University of Milan, Italy.
The main interests of Dr. Galetta are in thoracic surgical oncology (lung cancer, pleural disease, mediastinal disease, chest wall disease) and benign thoracic diseases.
Dr. Galetta participated to National and International Meetings as invited Speaker.
He is a Reviewer and Editor member for different Surgical and Oncological Journals.
He is author/co-author of 156 manuscript published on PUBMED, and of 15 Book Chapters.
Description
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.
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