Survival Analysis Based On The Surgical Approach To Lobectomy For Clinical Stage ?:Lung Adenocarcinoma Comparison Of Robotic,Video Assisted Thoracic Surgery Through Propensity Score Matching

Object:Da Vinci surgical system is widely used in thoracic surgery as a representative of the world's cutting-edge surgical robots.To compare the survival analysis among robotic,video-assisted thoracic surgery(VATS),in stage I lung adenocarcinoma,LUAD).Methods:From January 2012 to December 2018,291 patients(125 patients in the rats group and 166 patients in the VATS group)were included in the analysis.The difference was statistically significant(P < 0.05).The data of 114 pairs of patients were matched with the related sex,age,TNM stage,differentiation degree and smoking history in spss24.In propensity matching,the propensity score was matched by a scale of 1:1 and a caliper distance of 0.01 to create a treatment group with an approximate randomized effect,so the bias of non randomized treatment was partially eliminated.OS and DFS were estimated by Kaplan Meier method and log rank method,and the single variable and multi variable Cox proportional risk models were used for inter group comparison in the whole queue.Rank sum test and chi square test were used to calculate the survival rate of continuous variable and classified variable respectively,and the survival curve was drawn.The difference was statistically significant(P < 0.05).Result:There were 89 males and 139 females in 228 matched patients.There was no significant difference in sex,age,smoking history,differentiation degree,pathological type and TNM stage distribution between the two matched groups(P >0.05).RATS group got less blood lose [(43±32 m L for RATS vs(149±111)m L for VATS,P<0.05] and postoperative drainage [Day 1:(238±107)m L for RATS vs(302±171)m L for VATS;Day 2:(332±189)m L for RATS vs(356±191)m L for VATS,P<0.05].There were no significant difference for drainage time(9±5 for RATS vs 11±8for VATS,P>0.05)and postoperative hospital stay(12±6 for RATS vs 12±4for VATS,P>0.05)between the two groups.The RATS group harvested a more number of mean stations(5±2 for RATS vs 3±2 for VATS)and amounts(16±8 for RATS vs 11±8 for VATS)of the lymph nodes,P<0.05.There was no statistically significant difference of OS between RATS and VATS group [1-year OS: 98.8% vs 96.5%;3-year OS: 92.6%vs75.2%;5-year OS: 87.4 % vs51.1%;overall survival time(mean): 77 months vs 64 months,P>0.05];corresponding there had a statistically significant difference of DFS between the two groups [1-year DFS:94.1% vs 95.6%;3-year DFS:92.6%vs 75.2%;5-year DFS: 92.6% vs 65.4%;disease free survival time(mean): 78 months vs 63 months,P<0.05].The univariate analysis found that the amounts of the lymph nodes dissection was the prognostic factor for OS and tumor diameter,surgical approach,stations and amounts of the lymph nodes dissection were respectively the prognostic factors for DFS.However,multivariate analysis found that there was not independently factors for OS,but the tumor diameter and surgical approach were independently associated with DFS.Conclusion There was no significant difference about OS between the two groups,but the RATS got better DFS.Conclusion:There was no significant difference about OS between the two groups,but the RATS got better DFS.