Zhao J, Zhao Y, Qiu T, Jiao W, Xuan Y, Wang X, Wang Y, Luo Y
Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, P. R, China.
Indian J Cancer. 2015 Dec;52 Suppl 2:e130-3. doi: 10.4103/0019-509X.172510.
Due to the improvement of thoracoscopic technology and surgeon's ability, plenty of nonsmall cell lung cancer (NSCLC) was treated by video-assisted thoracic surgery (VATS). This study was designed to evaluate the quality of life (QOL) and survival in II stage NSCLC patients following lobectomy, comparing VATS with thoracotomy.
Between 2010 and 2012, 217 II stage NSCLC patients (VATS: 114 patients, OPEN: 103 patients) were enrolled in a long-standing, prospective observational lung cancer surgery outcomes study. Short-form 36 health survey (SF-36) and time to progression (TTP) were measured to evaluate the QOL and postoperative survival.
There were significant differences between the two groups in the preoperative radiation therapy and differentiation, and the VATS group had less postoperative complication, blood loss, intraoperative fluid administration, and shorter length of stay. Statistical analysis of SF-36 questionnaire revealed that VATS group score was higher on seven health dimensions: Bodily pain (BP), energy (EG), general health, physical functioning, mental health, SF, and role-physical (RP), but only BP, EG, and RP have statistical significance. Using survival analysis, there was no significant difference between VATS and OPEN group, in which the mean TTP of VATS group is 18.5 months, while OPEN group is 20 months.
VATS lobectomy tends to score higher on the QOL and functioning scales and has equivalent postsurgical survival compared with OPEN lobectomy for II stage nonsmall cell carcinoma patients.
由于胸腔镜技术和外科医生能力的提高，大量非小细胞肺癌（NSCLC）患者接受了电视辅助胸腔手术（VATS）治疗。本研究旨在评估II期NSCLC患者肺叶切除术后的生活质量（QOL）和生存率，并比较VATS与开胸手术的效果。
在2010年至2012年期间，217例II期NSCLC患者（VATS组：114例，开放手术组：103例）纳入了一项长期的前瞻性观察性肺癌手术结局研究。采用简短健康调查问卷（SF-36）和疾病进展时间（TTP）来评估生活质量和术后生存率。
两组患者在术前放疗和分化程度方面存在显著差异，VATS组术后并发症、失血量、术中补液量更少，住院时间更短。对SF-36问卷的统计分析显示，VATS组在七个健康维度上得分更高：身体疼痛（BP）、精力（EG）、总体健康、身体功能、心理健康、情感职能（SF）和躯体角色（RP），但只有BP、EG和RP具有统计学意义。采用生存分析，VATS组和开放手术组之间无显著差异，VATS组的平均TTP为18.5个月，而开放手术组为20个月。
对于II期非小细胞癌患者，VATS肺叶切除术在生活质量和功能量表上的得分往往更高，且术后生存率与开放肺叶切除术相当。
