TY - JOUR
T1 - Current status of surgery for clinical stage IA lung cancer in Japan
T2 - analysis of the national clinical database
AU - Ikeda, Norihiko
AU - Endo, Shunsuke
AU - Fukuchi, Eriko
AU - Nakajima, Jun
AU - Yokoi, Kohei
AU - Chida, Masayuki
AU - Date, Hiroshi
AU - Iwasaki, Akinori
AU - Yokomise, Hiroyasu
AU - Sato, Masami
AU - Okumura, Meinoshin
AU - Yamamoto, Hiroyuki
AU - Miyata, Hiroaki
AU - Kondo, Takashi
N1 - Funding Information:
We have no conflicts of interest to report. The Department of Healthcare Quality Assessment at The University of Tokyo, Japan (Eriko Fukuchi, Hiroyuki Yamamoto, and Hiroaki Miyata) is a social collaboration department supported by grants from the National Clinical Database, Johnson & Johnson K.K. and Nipro Co.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12
Y1 - 2020/12
N2 - Purpose: As the number of cases of early lung cancer in Japan grows, an analysis of the present status of surgical treatments for clinical stage IA lung cancer using a nationwide database with web-based data entry is warranted. Methods: The operative and perioperative data from 47,921 patients who underwent surgery for clinical stage IA lung cancer in 2014 and 2015 were obtained from the National Clinical Database (NCD) of Japan. Clinicopathological characteristics, surgical procedure, mortality, and morbidity were analyzed, and thoracotomy and video-assisted thoracic surgery (VATS) were compared. Results: The patients comprised 27,208 men (56.8%) and 20,713 women (43.2%); mean age, 69.3 years. Lobectomy was performed in 64.8%, segmentectomy in 15.2%, and wedge resection in 19.8%. The surgical procedures were thoracotomy in 12,194 patients (25.4%) and a minimally invasive approach (MIA) in 35,727 patients (74.6%). MIA was divided into VATS + mini-thoracotomy (n = 13,422, 28.0%) and complete VATS (n = 22,305, 46.5%). The overall postoperative mortality rate was 0.4%, being significantly lower in the MIA group than in the thoracotomy group (0.3% vs 0.8%, P < 0.001). Conclusions: Our analysis of data from the NCD indicates that MIA has become the new standard treatment for clinical stage IA lung cancer.
AB - Purpose: As the number of cases of early lung cancer in Japan grows, an analysis of the present status of surgical treatments for clinical stage IA lung cancer using a nationwide database with web-based data entry is warranted. Methods: The operative and perioperative data from 47,921 patients who underwent surgery for clinical stage IA lung cancer in 2014 and 2015 were obtained from the National Clinical Database (NCD) of Japan. Clinicopathological characteristics, surgical procedure, mortality, and morbidity were analyzed, and thoracotomy and video-assisted thoracic surgery (VATS) were compared. Results: The patients comprised 27,208 men (56.8%) and 20,713 women (43.2%); mean age, 69.3 years. Lobectomy was performed in 64.8%, segmentectomy in 15.2%, and wedge resection in 19.8%. The surgical procedures were thoracotomy in 12,194 patients (25.4%) and a minimally invasive approach (MIA) in 35,727 patients (74.6%). MIA was divided into VATS + mini-thoracotomy (n = 13,422, 28.0%) and complete VATS (n = 22,305, 46.5%). The overall postoperative mortality rate was 0.4%, being significantly lower in the MIA group than in the thoracotomy group (0.3% vs 0.8%, P < 0.001). Conclusions: Our analysis of data from the NCD indicates that MIA has become the new standard treatment for clinical stage IA lung cancer.
KW - Lung cancer
KW - National database
KW - Surgery
KW - VATS
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U2 - 10.1007/s00595-020-02063-x
DO - 10.1007/s00595-020-02063-x
M3 - Article
C2 - 32627065
AN - SCOPUS:85087462289
VL - 50
SP - 1644
EP - 1651
JO - Surgery Today
JF - Surgery Today
SN - 0941-1291
IS - 12
ER -