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Video-assisted thoracic surgery lobectomy: report of CALGB 39802--a prospective, multi-institution feasibility study.
J Clin Oncol. 2007 Nov 01; 25(31):4993-7.JC

Abstract

PURPOSE

To evaluate the technical feasibility and safety of video-assisted thoracic surgery (VATS) lobectomy for small lung cancers.

PATIENTS AND METHODS

The Cancer and Leukemia Group B 39802 trial was a prospective, multi-institutional study designed to elucidate the technical feasibility of VATS in early non-small-cell lung cancer (NSCLC) using a standard definition for VATS lobectomy (one 4- to 8-cm access and two 0.5-cm port incisions) that mandated videoscopic guidance and a traditional hilar dissection without rib spreading. Between 1998 and 2001, 128 patients with peripheral lung nodules < or = 3 cm in size with suspected NSCLC were prospectively registered for VATS lobectomy.

RESULTS

One hundred twenty-seven patients (66 males and 61 females; median age, 66 years; range, 37 to 86 years), with a performance status of 0 (74%) or 1 (26%), underwent surgery. Patients with lymph nodes more than 1 cm by computed tomography scan underwent mediastinal lymph node sampling to rule out N2 disease. One hundred eleven patients (87%) had stage I lung cancer, and 96 (86.5%) of these 111 patients underwent successful VATS lobectomies. The median procedure length was 130 minutes (range, 47 to 428 minutes), and median chest tube duration was 3 days (range, 1 to 14 days). Fifty-eight (60%) of 97 patients underwent diagnostic biopsy at lobectomy. Within 30 days, three (2.7%) of 111 patient deaths occurred, none of which were directly related to VATS technique; seven (7.4%) of 95 patients had grade 3 or greater complications, with only one case of bleeding.

CONCLUSION

A standardized approach to VATS lobectomy as specifically defined with avoidance of rib spreading is feasible.

Authors+Show Affiliations

Surgery Committee of the Cancer and Leukemia Group B (CALGB), Statistics Office of CALGB, and Respiratory Committee of CALGB, Chicago, IL, USA. Scott.Swanson@mountsinai.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17971599

Citation

Swanson, Scott J., et al. "Video-assisted Thoracic Surgery Lobectomy: Report of CALGB 39802--a Prospective, Multi-institution Feasibility Study." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 25, no. 31, 2007, pp. 4993-7.
Swanson SJ, Herndon JE, D'Amico TA, et al. Video-assisted thoracic surgery lobectomy: report of CALGB 39802--a prospective, multi-institution feasibility study. J Clin Oncol. 2007;25(31):4993-7.
Swanson, S. J., Herndon, J. E., D'Amico, T. A., Demmy, T. L., McKenna, R. J., Green, M. R., & Sugarbaker, D. J. (2007). Video-assisted thoracic surgery lobectomy: report of CALGB 39802--a prospective, multi-institution feasibility study. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 25(31), 4993-7.
Swanson SJ, et al. Video-assisted Thoracic Surgery Lobectomy: Report of CALGB 39802--a Prospective, Multi-institution Feasibility Study. J Clin Oncol. 2007 Nov 1;25(31):4993-7. PubMed PMID: 17971599.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Video-assisted thoracic surgery lobectomy: report of CALGB 39802--a prospective, multi-institution feasibility study. AU - Swanson,Scott J, AU - Herndon,James E,2nd AU - D'Amico,Thomas A, AU - Demmy,Todd L, AU - McKenna,Robert J,Jr AU - Green,Mark R, AU - Sugarbaker,David J, PY - 2007/11/1/pubmed PY - 2007/12/6/medline PY - 2007/11/1/entrez SP - 4993 EP - 7 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 25 IS - 31 N2 - PURPOSE: To evaluate the technical feasibility and safety of video-assisted thoracic surgery (VATS) lobectomy for small lung cancers. PATIENTS AND METHODS: The Cancer and Leukemia Group B 39802 trial was a prospective, multi-institutional study designed to elucidate the technical feasibility of VATS in early non-small-cell lung cancer (NSCLC) using a standard definition for VATS lobectomy (one 4- to 8-cm access and two 0.5-cm port incisions) that mandated videoscopic guidance and a traditional hilar dissection without rib spreading. Between 1998 and 2001, 128 patients with peripheral lung nodules < or = 3 cm in size with suspected NSCLC were prospectively registered for VATS lobectomy. RESULTS: One hundred twenty-seven patients (66 males and 61 females; median age, 66 years; range, 37 to 86 years), with a performance status of 0 (74%) or 1 (26%), underwent surgery. Patients with lymph nodes more than 1 cm by computed tomography scan underwent mediastinal lymph node sampling to rule out N2 disease. One hundred eleven patients (87%) had stage I lung cancer, and 96 (86.5%) of these 111 patients underwent successful VATS lobectomies. The median procedure length was 130 minutes (range, 47 to 428 minutes), and median chest tube duration was 3 days (range, 1 to 14 days). Fifty-eight (60%) of 97 patients underwent diagnostic biopsy at lobectomy. Within 30 days, three (2.7%) of 111 patient deaths occurred, none of which were directly related to VATS technique; seven (7.4%) of 95 patients had grade 3 or greater complications, with only one case of bleeding. CONCLUSION: A standardized approach to VATS lobectomy as specifically defined with avoidance of rib spreading is feasible. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/17971599/Video_assisted_thoracic_surgery_lobectomy:_report_of_CALGB_39802__a_prospective_multi_institution_feasibility_study_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2007.12.6649?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -