Mid-term results of completely portal robotic lobectomy for stage I & II non-small cell lung cancer

Abstract

Background: Minimally invasive robotic-assisted thoracic surgery is an increasingly popular platform for oncological thoracic resection. The aim of this study is to evaluate the feasibility of completely portal robotic lobectomy for patients with early non-small cell lung cancer (NSCLC), analysing the perioperative and midterm results. Methods: This is a single-institution retrospective cohort study of consecutive patients who underwent completely portal robotic lobectomy for early stage NSCLC over a 53-month period. Results: A total of 59 consecutive patients were included in this study. Median operative time was 155 min (range, 80-313 min). Conversion rate was 13.6%. Median intensive care/high dependency unit stay, chest tube duration and length of hospital stay were 1 day (range, 0-4 days), 2 days (range, 1-20 days) and 4 days (range, 2-30 days) respectively; 98.2% of patients achieved R0 resection. Overall, 23.7% had minor complications. There was no perioperative (30-day) mortality in this study. Final pathological staging distribution was 55.9% stage 1A, 23.7% stage 1B, 10.2% stage 2A and 10.2% stage 2B; 23% were upstaged after pathological staging. Median follow-up was 33 months (range, 3-70 months). The 3-year overall survival and recurrence-free survival were 86.2% (95% CI, 72.0-96.8) and 69% (95% CI, 56.1-81.9) respectively. The 3-year overall survival and recurrence free survival for stage 1 patients were 88.4% (95% CI, 77.4-99.4) and 75.6% (95% CI, 62.3-88.9) respectively. Conclusions: By clearly defining completely portal robotic lobectomy, it is possible to delivery promising perioperative and mid-term results for early stage primary lung cancer, even in a geographical location that has yet to assimilate this technology.