Critical appraisal:Cao C, Zhu ZH, Yan TD, Wang Q, Jiang G, Liu L, et al 2013

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Critical Appraisal

Article being appraised

Cao C, Zhu ZH, Yan TD, Wang Q, Jiang G, Liu L, et al. Video-assisted thoracic surgery versus open thoracotomy for non-small-cell lung cancer: a propensity score analysis based on a multi-institutional registry. Eur J Cardiothorac Surg 2013 Nov;44(5):849-54 Available from: http://www.ncbi.nlm.nih.gov/pubmed/23956268.


Applicable clinical question

Key Facts

Study Design

case-control study

Study aims:

To compare long-term survival and oncological outcomes for patients with non-small-cell lung cancer (NSCLC) who underwent video-assisted thoracic surgery (VATS) or conventional open lobectomy

Number of Patients:

2916

Reported outcome(s):

5-year survival
median survival
perioperative mortality rate

Results of outcome(s):

VATS lobectomy did not demonstrate any statistically significant differences in long-term survival [median 102.9 mths] compared with thoracotomy [99.4 mths] (p = 0.07)
Perioperative mortality rate was 1.1% for the open group and 0.8% for the VATS group (p= NS)

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-2

Risk of bias
Moderate risk of bias Comments:

Risk of bias assessment: case-control study

Subject selection
Cases
Selected group (e.g. multi-institution study)
Adequacy of case definition
Taken from medical records, self report without independent validation
Controls
From same population as cases and same exclusion criteria used
Comparability of groups on demographic characteristics and important potential confounders
Comparable (or matched)
Ascertainment of exposure/treatment
No or not described
Follow-up complete and all patients included in the analysis?
Non-response unlikely to introduce bias (>80% in both cases and controls)
Size of effect
3 Reason for decision: Please replace this text and briefly describe the reasons for your rating
Relevance of evidence
1 Additional comments: Please replace this text and briefly describe the reasons for your rating
Result of appraisal

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Completed by

Associate Professor Gavin Wright MD FRACS PhD


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Article
Cao C, Zhu ZH, Yan TD, Wang Q, Jiang G, Liu L, et al. Video-assisted thoracic surgery versus open thoracotomy for non-small-cell lung cancer: a propensity score analysis based on a multi-institutional registry. Eur J Cardiothorac Surg 2013 Nov;44(5):849-54 Available from: http://www.ncbi.nlm.nih.gov/pubmed/23956268.
Assigned to
User:Gavin.wright
Topic area
Guidelines:Lung cancer/Treatment/Non-small-cell stage I operable
Clinical question
Form
Form:Critical appraisal


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