Video-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer

We designed a prospective trial to determine the long-term prognosis of vid eo-assisted thoracoscopic (VATS) lobectomy versus conventional lobectomy fo r patients with clinical stage IA (T1N0M0) lung cancer. Between January 199 3 and June 1994, 100 consecutive patients with clinical stage IA non-small cell lung carcinoma underwent either conventional lobectomy through an open thoracotomy (open group; n = it) or VATS lobectomy (VATS group; a = 48). L ymph node dissections were performed in a similar manner in both groups. No significant differences were observed in the number of dissected lymph nod es between the 2 groups. Pathologic N1 and N2 disease was found in 3 and 1 patients, respectively, from the open group, and in 2 and 1 patients, respe ctively, from the VATS group. During the follow-up period, distant metastas es and focal or regional recurrences developed in 7 and 3 of the open group patients, respectively, and in 2 and 3 of the VATS group patients, respect ively. Two and one of the open and VATS group patients developed second pri mary cancers, respectively. The overall survival rates 5 years after surger y were 85% and 90% in the open and VATS groups, respectively (log-rank test , p = 0.74; generalized Wilcoxon test, p = 0.91). VATS lobectomy with lymph node dissection achieved an excellent 5-year survival, similar to that ach ieved by the conventional approach.