Current status of surgery for clinical stage IA lung cancer in Japan: analysis of the national clinical database

Norihiko Ikeda, Shunsuke Endo, Eriko Fukuchi, Jun Nakajima, Kohei Yokoi, Masayuki Chida, Hiroshi Date, Akinori Iwasaki, Hiroyasu Yokomise, Masami Sato, Meinoshin Okumura, Hiroyuki Yamamoto, Hiroaki Miyata, Takashi Kondo

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalSurgery today
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • Lung cancer
  • National database
  • Surgery
  • VATS

ASJC Scopus subject areas

  • Surgery

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    Ikeda, N., Endo, S., Fukuchi, E., Nakajima, J., Yokoi, K., Chida, M., Date, H., Iwasaki, A., Yokomise, H., Sato, M., Okumura, M., Yamamoto, H., Miyata, H., & Kondo, T. (Accepted/In press). Current status of surgery for clinical stage IA lung cancer in Japan: analysis of the national clinical database. Surgery today. https://doi.org/10.1007/s00595-020-02063-x