Dr. Merritt on Robotic Lobectomy Versus VATS and Open Thoracotomy in NSCLC

Robert E. Merritt, MD, FACS, associate professor of surgery, The Ohio State University Wexner Medical Center, and general thoracic surgeon and director, division of thoracic surgery, The Ohio State University Comprehensive Cancer Center—The James, discusses the long-term oncologic outcomes of robotic lobectomy versus video-assisted thoracoscopic surgery (VATS) and open thoracotomy in early-stage non-small-cell lung cancer (NSCLC).

In an observational study, investigators examined data from The Ohio State University Comprehensive Cancer Center—The James, says Merritt. Specifically, a comparable cohort of patients who underwent robotic lobectomy, VATS, and robotic lobectomy were analyzed. Short-term outcomes, including post-operative complications, were examined. Investigators noted that patients who had robotic surgery and VATS had a shorter hospital stay and experienced less pulmonary complications compared with those who underwent an open thoracotomy, says Merritt.

In terms of the long-term oncologic outcomes, recurrence-free survival and overall survival (OS) were very similar across all 3 groups, adds Merritt. Specifically, the incidence for locoregional recurrence was 7% with robotic lobectomy, 6% with VATS, and 8% with open thoracotomy (P =.9). Additionally, the 5-year OS for robotic-assisted, VATS, and open lobectomy was 63%, 55%, and 65%, respectively (P =.56).

The importance of this study was that it showed that robotic surgery, a newer approach, was associated with durable freedom of recurrence and long-term survival that was equivalent to those achieved with VATS and open thoracotomy. Not only are the short term outcomes better with robotic lobectomy than they are with open surgery, but the long-term outcomes are equivalent, which validates robotic surgery as a preferable choice for patients with early-stage NSCLC, concludes Merritt.