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The UK trial that settled how a lung should be removed: keyhole surgery leaves people functioning better at five weeks and causes fewer serious problems after discharge, with the same survival.
VIOLET randomised 503 people with early-stage non-small-cell lung cancer to video-assisted thoracoscopic lobectomy or open lobectomy. At five weeks, median physical function on the EORTC quality-of-life questionnaire was 73 after keyhole surgery against 67 after open surgery, a mean difference of 4.65 points (95 percent confidence interval 1.69 to 7.61). Serious adverse events after discharge occurred in 30.7 percent of the keyhole group against 37.8 percent of the open group (risk ratio 0.81, 0.66 to 1.00). At 52 weeks there was no difference in progression-free survival (hazard ratio 0.74) or overall survival (0.67).
The result matters more now than when it was published: three quarters of English lung resections are done by keyhole or robot, and the National Lung Cancer Audit reports that the number of resections is rising steeply as screening finds more early cancers.
Shares Lobectomy, Resectable stage I to III non-small-cell lung cancer, Lung cancer (all types), Non-small-cell lung cancer and the tag uk.
Shares University Hospitals Birmingham / University of Birmingham Cancer Research Centre, Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares The Christie NHS Foundation Trust, Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Resectable stage I to III non-small-cell lung cancer, Non-small-cell lung cancer and the tags surgery, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.