KEY TAKEAWAYS
- The study aimed to investigate the safety and feasibility of simultaneous bilateral VATS as a treatment for bilateral synchronous MPLC.
- Researchers concluded that simultaneous bilateral VATS offers safe and effective treatment for early-stage bilateral lung nodules.
The treatment for bilateral synchronous multiple primary lung cancers (MPLC) remains challenging. Simultaneous bilateral video-assisted thoracic surgery (VATS) may be an optimal treatment with curative intent, but its safety and feasibility are controversial.
Libing Yang and the team aimed to assess the safety and feasibility of simultaneous bilateral VATS in treating bilateral synchronous MPLC.
They performed an inclusive analysis involving 158 patients who underwent simultaneous bilateral VATS (simultaneous group) and 79 who underwent 2-staged bilateral VATS (2-staged group). Medical records of these patients were retrospectively reviewed and analyzed to compare outcomes and evaluate the safety and feasibility of simultaneous versus 2-staged approaches in managing bilateral synchronous MPLC.
The majority of patients were female and non-smokers. The most common surgical plan was lobectomy and contralateral wedge resection in both groups. There was no significant difference in the postoperative complication rate between the simultaneous and 2-staged groups (13.3% vs. 11.4%, P = 0.73).
Patients who underwent simultaneous bilateral resection had shorter hospital stays, shorter anesthesia time, and less chest drainage compared with those who underwent 2-staged resection. Advanced TNM stage, complicated surgical plan, and aggressive lymph node resection were risk factors for postoperative complications in simultaneous bilateral VATS. Patients in the 2 groups had similar overall survival (OS) and disease-free survival (DFS) (P = 0.2).
The study concluded that simultaneous bilateral VATS for bilateral lung nodule resection is as safe and feasible as 2-staged bilateral VATS. Patients who underwent simultaneous bilateral resection showed similar or even better outcomes compared to the 2-staged group. Simultaneous bilateral VATS appears to be a potentially optimal treatment option, particularly for patients with early cTNM stage and good physical condition.
This study is funded by National High Level Hospital Clinical Research Funding 2022-PUMCH-A-259, 2022-PUMCH-B-011.
Source: https://pubmed.ncbi.nlm.nih.gov/38997716/
Yang L, Guo C, Zhang Y, et al. (2024). “Simultaneous bilateral video-assisted thoracic surgery is safe and feasible for multiple primary lung cancers.” J Cardiothorac Surg. 2024 Jul 12;19(1):436. doi: 10.1186/s13019-024-02941-2. PMID: 38997716; PMCID: PMC11242011.
