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首页> 外文期刊>Thoracic cancer. >Is video-assisted thoracoscopy a sufficient approach for mediastinal lymph node dissection to treat lung cancer after neoadjuvant therapy?
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Is video-assisted thoracoscopy a sufficient approach for mediastinal lymph node dissection to treat lung cancer after neoadjuvant therapy?

机译：视频辅助胸腔镜检查了纵隔淋巴结解剖的足够方法，以治疗新辅助治疗后的肺癌吗？

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The role of video-assisted thoracoscopic surgery (VATS) in mediastinal lymph node dissection (MLND) for non-small cell lung cancer (NSCLC) following neoadjuvant therapy remains controversial. The aim of this study was to demonstrate the sufficiency of VATS by evaluating perioperative and long-term outcomes. Patients with locally advanced NSCLC and treated with radical surgery after neoadjuvant therapy were identified in our database. The thoroughness of MLND was compared by approach. Multivariable logistic regression analysis was used to evaluate predictors of sufficient MLND. Propensity score matching was performed. Kaplan-Meier and Cox proportional hazard analyses were used to assess long-term survival. Of the 127 enrolled patients, 56 underwent attempted VATS and 71 underwent thoracotomy. Multivariable logistic regression analysis revealed that approach was not a predictor of sufficient MLND (odds ratio 0.81, 95% confidence interval [CI] 0.364-1.803; P =?0.606). After matching, 28 pairs of patients were selected from the two groups. There was no significant difference between the numbers of dissected lymph nodes (15 vs. 20; P =?0.191) and nodal stations (7 vs. 7; P =?0.315). Recurrence-free (log-rank P =?0.613) and overall survival (log-rank P =?0.379) was similar in both groups. Multivariable Cox proportional hazards model analysis indicated that VATS was not an independent predictor of recurrence-free (hazard ratio 0.955, 95% CI 0.415-2.198; P =?0.913) or overall survival (hazard ratio 0.841, 95% CI 0.338-2.093; P =?0.709). Compared to thoracotomy, VATS is a sufficient approach for MLND to treat locally advanced NSCLC following neoadjuvant therapy without compromising long-term survival. ? 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
机译：在Neoadjuvant治疗后的非小细胞肺癌（NSCLC）中的纵隔淋巴结分布（MLND）中的视频辅助胸腔镜手术（VATS）的作用仍然存在争议。本研究的目的是通过评估围手术期和长期结果来证明VATS的充分性。在我们的数据库中确定了局部晚期NSCLC和Neoadjuvant治疗后的自由基手术治疗。通过方法比较MLND的彻底性。多变量逻辑回归分析用于评估足够MLND的预测因子。进行倾向得分匹配。 Kaplan-Meier和Cox比例危险分析用于评估长期存活。 127名患者的患者中，56名经历了VATS和71次接受过胸廓切开术。多变量逻辑回归分析显示，方法不是足够的MLND的预测因子（差距0.81,95％置信区间[CI] 0.364-1.803; P = 0.606）。匹配后，从两组中选择28对患者。解剖淋巴结的数量没有显着差异（15 vs.20; p = 0.191）和节点站（7 Vs.7; P = 0.315）。无复发（Log-Rank P = 0.613）和整体存活（Log-Rank P = 0.379）在两组中相似。多变量的Cox比例危害模型分析表明，VATS不是无复发（危害比0.955,95％CI 0.415-2.198; P = 0.913）或整体存活（危险比0.841,95％CI 0.338-2.093; p = 0.709）。与胸廓切开术相比，VATS是MLND的足够方法，以治疗Neoadjuvant治疗后的局部晚期NSCLC而不损害长期存活。 ？ 2019年的作者。中国肺部肿瘤集团和约翰瓦里和儿子澳大利亚发表的胸癌

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