Prospective comparison of postoperative quality of life (QOL) in patients undergoing lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for non-small cell lung cancer (NSCLC).

7543 Background: VATS lobectomy in early stage NSCLC is thought to have benefits over thoracotomy with regard to postoperative recovery and QOL, but prospective comparative data is lacking.,A prospective, non-randomized trial was performed comparing postoperative QOL in patients undergoing lobectomy for pathologic stage I NSCLC either by VATS or thoracotomy. Validated patient-reported measures were administered pre- and postoperatively. Comparison of categorical variables was done by Fisher's exact test, continuous data by Wilcoxon's test, and QOL differences using ANOVA models adjusting for stage and baseline scores.,There were 129 eligible patients (62 thoracotomy, 67 VATS). There were no differences between groups with respect to gender distribution, age, preoperative lung function, or tumor size. There was a greater proportion of pathologic stage IB disease (53% versus 19%, p<0.01) in the thoracotomy group. There were no operative mortalities in either group. VATS patients had a shorter median length of hospital stay (4 days, range 2-18 versus 6 days, range 3-27, p=0.002). At a median follow-up of 23 days (range 11-34) after discharge use of VATS resulted in a higher proportion of patients with postoperative patient-reported Karnofsky performance status ≥90 compared to thoracotomy (68% versus 38%, p=0.02). In addition, VATS patients had improved outcomes with respect to dyspnea, fatigue and pain relative to baseline ( Table ). There were no differences in activities of daily living or global QOL as measured by MOS SF-36.,VATS for lobectomy in early stage NSCLC resulted in shorter length of stay and significant improvements in immediate postoperative performance status, dyspnea, fatigue and pain compared with thoracotomy. [Table: see text] No significant financial relationships to disclose.