The goal of this multicenter observational study is to evaluate the long-term survival and perioperative outcomes of sleeve lobectomy in robotic-assisted thoracic surgery (RATS) for patients with central lung cancer when compared with video-assisted thoracic surgery (VATS) approach, both of which have been already applied to these patients in minimally invasive surgical techniques as part of their regular medical care recently. The main question it aims to answer is:
Are RATS sleeve lobectomy associated with similar or even better long-term survival and perioperative outcomes for patients with central lung cancer when compared with the VATS approach?
Age ≥ 18 years;
Clinically suspected lung cancer with a high likelihood of undergoing sleeve lobectomy;
Postoperative histopathological diagnosis confirms non-small cell lung cancer (NSCLC);
No history of malignancy within the past 5 years;
Unable to undergo surgical resection due to surgical contraindications;
Postoperative pathology does not confirm non-small cell lung cancer (NSCLC), including but not limited to benign lesions, small cell lung cancer, metastatic tumors, or an insufficient or indeterminate histopathology report;
History of malignancy within the past 5 years;
Unable to obtain follow-up data;
This study will retrospectively enroll 450 consecutive patients with stage IA\~IIIB non-small cell lung cancer performed sleeve lobectomy in minimally invasive surgical techniques (RATS or VATS) from January 2015 to September 2024 in all three related centers. Baseline clinical information, surgery-related data, short-term postoperative outcomes, and long-term survival data (3-year OS and RFS) will be collected and analyzed using the propensity score matching method.
Cohort
Retrospective
RATS Group
Procedure/SurgeryThe participants with centrally located lung cancer in this group were performed sleeve lobectomy in robotic-assisted thoracic surgery (RATS) approach, which has been already applied to these patients in minimally invasive surgical techniques as part of their regular medical care recently.
VATS group
Procedure/SurgeryThe participants with centrally located lung cancer in this group were performed sleeve lobectomy in video-assisted thoracic surgery (VATS) approach.
3-year RFS
In this study, the investigators will focus on the 3-year recurrence-free survival (RFS) of the participants between the two groups (RATS vs. VATS) for the comparison of the long-term oncologic outcomes, as the primary outcome.
3-year OS
The investigators will also focus on the 3-year overall survival (OS) of the participants between the two groups (RATS vs. VATS) for the comparison of the long-term oncologic outcomes, as the secondary outcome.
Intraoperative blood loss
The intraoperative blood loss will be investigated between RATS versus VATS sleeve lobectomy as one of the perioperative outcomes, measured in milliliter (mL).
Operative time
The operative time will be investigated between RATS versus VATS sleeve lobectomy as one of the perioperative outcomes, measured in minute (min).
Length of hospital stay
The length of hospital stay will be investigated between RATS versus VATS sleeve lobectomy as one of the perioperative outcomes, measured in day.
Postoperative drainage
The postoperative drainage will be investigated between RATS versus VATS sleeve lobectomy as one of the perioperative outcomes, measured in milliliter (mL).
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Second Affiliated Hospital, School of Medicine, Zhejiang University
Lead sponsor
Shanghai Chest Hospital of Shanghai Jiao Tong University
Collaborator
Sir Run Run Shaw Hospital
Collaborator
