Chest. 2023 Jan 5:S0012-3692(23)00015-6. doi: 10.1016/j.chest.2022.12.037. Online ahead of print.
BACKGROUND: Robotic-assisted lobectomy (RAL) is increasingly employed as an alternative to video-assisted lobectomy (VAL) for resectable non-small-cell lung cancer (NSCLC). However, there is little evidence for any difference in the postoperative health-related quality of life (HRQoL) between these two approaches.
RESEARCH QUESTION: Is robotic-assisted lobectomy (RAL) superior to video-assisted lobectomy (VAL) in improving quality of life in patients with resectable non-small-cell lung cancer (NSCLC)?
STUDY DESIGN AND METHODS: We performed a single-center, open-label randomized clinical trial from May 2017 to May 2020 with 320 patients undergoing RAL or VAL for resectable NSCLC enrolled (RVlob trial, NCT03134534). Postoperative pain was evaluated with the visual analogue score (VAS) or numeric rating score (NRS) on postoperative day 1 and at weeks 4, 24, and 48. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30), EORTC Quality of Life Questionnaire in Lung Cancer (QLQ-LC13), and the European Quality of Life 5 Dimensions (EQ-5D) questionnaire were also administered at weeks 4, 24 and 48 after surgery.
RESULTS: 157 patients underwent RAL and 163 had VAL. The mean pain score of patients after RAL was statistically lower at week 4 (2.097 ± 0.111 vs 2.431 ± 0.108, p=0.032). QLQ-C30 and QLQ-LC13 summary scores (p>0.05) were similar for both RAL and VAL during the first 48 weeks of follow-up. HRQoL score assessed with the EQ-5D questionnaire was also comparable between the two groups (p＞0.05) during the whole study period.
INTERPRETATION: Both RAL and VAL showed satisfactory and comparable HRQoL and postoperative pain up to 48 weeks after surgery, despite some minor statistical differences at week 4.
CLINICAL TRIAL REGISTRATION: NCT03134534 (http://www.