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WCLC 2019: Video-Assisted Thoracic Surgery vs Open Surgery in Lung Cancer


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Video-assisted thoracic surgery was associated with lower in-hospital complications and a shorter length of stay compared with open surgery among British patients who were diagnosed with early-stage lung cancer, according to research presented by Lim et al at the International Association for the Study of Lung Cancer (IASLC) 2019 World Conference on Lung Cancer (WCLC) (Abstract PL02.06).

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Video-assisted thoracoscopic surgery is a minimally invasive surgical technique using small incisions. A small camera transmits images of the inside of the chest onto a video monitor, guiding the surgeon in performing the procedure. Open surgery is achieved through a long cut in the chest and the ribs are spread open with the surgeon operating through direct vision into the chest. A lobectomy for lung cancer can be achieved by either approach.

VIOLET Trial

The National Institute of Healthcare Research funded the trial, called VIOLET, because there was limited information comparing video-assisted thoracic surgery with open surgery for lobectomy among patients with lung cancer.

Researchers randomly assigned 503 patients with lung cancer at nine surgery centers in the United Kingdom to undergo either video-assisted thoracoscopic surgery or open surgery. The average age of the patients was 69 years, and 49.5% were male.

KEY POINTS

  • Patients who received video-assisted thoracoscopic surgery had a significant reduction of overall in-hospital complications (32.8%) compared to patients who received open surgery (44.3%).
  • Patients who had undergone video-assisted thoracoscopic surgery stayed in the hospital 1 day less than patients who were given open surgery.

Results

After randomization, researchers found that patients who received video-assisted thoracoscopic surgery had a significant reduction of overall in-hospital complications (32.8%) compared to patients who received open surgery (44.3%). Additionally, patients who had undergone video-assisted thoracoscopic surgery stayed in the hospital 1 day less than patients who were given open surgery.

“The VIOLET Trial is the largest randomized trial conducted to date to compare clinical efficacy, safety, and oncologic outcomes of video-assisted thoracoscopic surgery vs open surgery for lung cancer,” said first study author Eric Lim, MD, in a press release. “The study achieved its positive results without any compromise to early oncologic outcomes—pathologic complete resection and upstaging of mediastinal lymph nodes.”

Disclosure: For full disclosures of the study authors, visit wclc2019.iaslc.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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