Purpose: Video-assisted resections of non-small cell lung cancer (NSCLC) are now performed worldwide; however, its validity as an oncologic surgical modality still remains to be elucidated. Methods: A consecutive series of 139 clinical stage IA NSCLC patients who underwent video-thoracoscopy combined with an access thoracotomy (VATS) or a standard open surgery (OR) were prospectively investigated regarding their status after undergoing a nodal dissection and their disease-free survival. Results: Both the VATS (72 patients) and OR groups (67 patients) contained comparable populations in terms of age, sex, histological type, and surgical morbidity, and showed comparable operation time and estimated blood loss. The number of dissected nodes on the right/left side was 25.3/19.5 in the VATS group and 25.6/22.9 in the OR group (P = 0.923/0.313). A pathologic examination revealed the proportion of upstaged patients was 18% in the VATS group and 27% in the OR group (P = 0.439). The disease-free survival rates for both groups were almost completely identical, with rates at 5 years of 76.5% and 79.2%, respectively (P = 0.908). Conclusion: VATS is therefore considered to be an adequate oncologic surgery for clinical stage IA NSCLC, and is also appropriate for the postoperative adjuvant era.
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