Critical appraisal:Murakawa T, Ichinose J, Hino H, Kitano K, Konoeda C, Nakajima J 2015

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Critical Appraisal

Article being appraised

Murakawa T, Ichinose J, Hino H, Kitano K, Konoeda C, Nakajima J. Long-Term Outcomes of Open and Video-Assisted Thoracoscopic Lung Lobectomy for the Treatment of Early Stage Non-small Cell Lung Cancer are Similar: A Propensity-Matched Study. World J Surg 2015 Jan 6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25561187.


Applicable clinical question

Key Facts

Study Design

case-control study

Study aims:

To compare short and long term outcomes of VATS and open lobectomies

Number of Patients:

202

Matched from overall single-centre population of only 285 pts.
Reported outcome(s):

Mean operation time
Blood loss
Chest tube duration
Hospital stay
Recurrence-free survival rates
Cancer-specific survival rates
Overall survival rates

Results of outcome(s):

Mean operation time favoured VATS (208.3–232.9 min) over thoracotomy (230.8–259.4 min), p= 0.0134
Blood loss favoured VATS (133–222 ml) over thoracotomy (235–452 ml), p< 0.0001
Chest tube duration favoured VATS (4.2–5.8 days) over thoracotomy (4.2–5.8 days), p= 0.0095
Hospital stay favoured VATS (8.4–11.3) over thoracotomy (10.9–14.6), p= 0.0013
Relapse rates were no different between groups, p= 0.11
Recurrence-free survival rates were no different between groups, p= 0.3946
Cancer-specific survival rates were no different between groups, p= 0.7064
Overall survival rates were no different between groups, 0.292

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-2

Risk of bias
High risk of bias Comments: Please replace this text and include any additional comments in regards to your quality rating

Risk of bias assessment: case-control study

Subject selection
Cases
Highly selected or not described (e.g. single-institution study)
Adequacy of case definition
Taken from medical records, self report without independent validation
Controls
Selected group (e.g. hospital controls)
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?
Complete response
Size of effect
2 Reason for decision: Survival rates of all types were similar. Complication rates with significance for cost or quality of life favoured VATS.
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
Murakawa T, Ichinose J, Hino H, Kitano K, Konoeda C, Nakajima J. Long-Term Outcomes of Open and Video-Assisted Thoracoscopic Lung Lobectomy for the Treatment of Early Stage Non-small Cell Lung Cancer are Similar: A Propensity-Matched Study. World J Surg 2015 Jan 6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25561187.
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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