Frontiers in oncology · 2025
The curative effect analysis of simultaneous U-VATS for bilateral multiple primary early-stage lung cancers.
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Shi Miao, Wang Long-Fei, Zhang Xue-Chi, Tang Li-Wei, Zheng Lei, Hu Wen-Tao, Liang Zhi-Gang
Аннотация
BACKGROUND: The incidence of multiple primary lung cancers (MPLCs) has been on the rise over the past decade, yet optimal surgical strategies remain debated. This study compared perioperative outcomes and long-term quality of life (QoL) between simultaneous and staged uniportal video-assisted thoracoscopic surgery (U-VATS) for bilateral early-stage MPLC.
METHODS: A retrospective cohort analyzed 69 patients undergoing simultaneous (n=28) or staged (n=41) U-VATS between March 2021 and December 2023. A comparative statistical analysis was conducted to assess perioperative efficacy and long-term QoL between simultaneous versus staged U-VATS in patients with bilateral synchronous MPLCs.
RESULTS: The simultaneous group exhibited smaller tumors (P=0.002) and included more smokers (P=0.019). Compared to staged surgery, simultaneous U-VATS resulted in a shorter hospital stay (8 vs. 14 days, P<0.001), reduced non-steroidal drug use (240 vs. 440 mg, P<0.001), and lower costs (CNY 41218.11 vs. CNY 68041.55, P<0.001), with comparable operative times (P=0.193). Pulmonary infections were less common following simultaneous surgery (3.6% vs. 24.4%, P=0.045). No 30-day mortality occurred. Longitudinal QoL assessment using a standardized 8-item symptom scale (cough, polypnea, pain, fatigue, sweating, insomnia, constipation, throat irritation) identified significant advantages for simultaneous surgery in polypnea (P=0.015) and pain control (P=0.013), whereas remaining symptoms showed comparable trajectories (all P>0.05).
CONCLUSION: Simultaneous U-VATS may be a safe, cost-effective option for early-stage MPLC, particularly in patients with smaller tumors. Larger multicenter studies are warranted to validate these findings.
METHODS: A retrospective cohort analyzed 69 patients undergoing simultaneous (n=28) or staged (n=41) U-VATS between March 2021 and December 2023. A comparative statistical analysis was conducted to assess perioperative efficacy and long-term QoL between simultaneous versus staged U-VATS in patients with bilateral synchronous MPLCs.
RESULTS: The simultaneous group exhibited smaller tumors (P=0.002) and included more smokers (P=0.019). Compared to staged surgery, simultaneous U-VATS resulted in a shorter hospital stay (8 vs. 14 days, P<0.001), reduced non-steroidal drug use (240 vs. 440 mg, P<0.001), and lower costs (CNY 41218.11 vs. CNY 68041.55, P<0.001), with comparable operative times (P=0.193). Pulmonary infections were less common following simultaneous surgery (3.6% vs. 24.4%, P=0.045). No 30-day mortality occurred. Longitudinal QoL assessment using a standardized 8-item symptom scale (cough, polypnea, pain, fatigue, sweating, insomnia, constipation, throat irritation) identified significant advantages for simultaneous surgery in polypnea (P=0.015) and pain control (P=0.013), whereas remaining symptoms showed comparable trajectories (all P>0.05).
CONCLUSION: Simultaneous U-VATS may be a safe, cost-effective option for early-stage MPLC, particularly in patients with smaller tumors. Larger multicenter studies are warranted to validate these findings.