Evidence map›Paper›PMID 36524582›Full record

Trial reportHealth technology assessment (Winchester, England)2022

Impact of video-assisted thoracoscopic lobectomy versus open lobectomy for lung cancer on recovery assessed using self-reported physical function: VIOLET RCT.

Eric Lim, Rosie A Harris, Holly E McKeon, Timothy Jp Batchelor, Joel Dunning, Michael Shackcloth, Vladimir Anikin, Babu Naidu, Elizabeth Belcher, Mahmoud Loubani and 10 more

Open access · diamondAbstract readRandomized Controlled TrialMulticenter StudyEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Health technology assessment (Winchester, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 3 pooled it
12.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 3 syntheses or guidelines pooled it, 86 citations in OpenAlex.

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2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 11 institutions in 1 country.

Eric LimAcademic Division of Thoracic Surgery, The Royal Brompton and Harefield Hospitals, London, UK.ORCID 0000-0002-9078-3226
Rosie A HarrisClinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-2405-667X
Holly E McKeonClinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-0220-503X
Timothy Jp BatchelorThoracic Surgery, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.ORCID 0000-0003-4103-6061
Joel DunningDepartment of Cardiothoracic Surgery, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.ORCID 0000-0001-8792-5089
Michael ShackclothDepartment of Thoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.ORCID 0000-0002-6494-9907
Vladimir AnikinAcademic Division of Thoracic Surgery, The Royal Brompton and Harefield Hospitals, London, UK.ORCID 0000-0001-5634-9306
Babu NaiduDepartment of Thoracic Surgery, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.ORCID 0000-0003-1576-230X
Elizabeth BelcherCardiothoracic Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.ORCID 0000-0002-8408-0452
Mahmoud LoubaniDepartment of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK.ORCID 0000-0003-1826-6686
Vipin ZamvarDepartment of Cardiothoracic Surgery, Edinburgh Royal Infirmary, Edinburgh, UK.ORCID 0000-0003-2447-828X
Lucy DabnerClinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0001-7269-1945
Timothy BrushClinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-9266-6867
Elizabeth A StokesHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0002-4179-1369
Sarah WordsworthHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0002-2361-3040
Sangeetha ParamasivanPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0001-7329-9574
Alba RealpePopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0001-9502-3907
Daisy ElliottNational Institute for Health and Care Research Bristol and Weston Biomedical Research Centre, Surgical Innovation Theme, Centre for Surgical Research, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0001-8143-9549
Jane BlazebyNational Institute for Health and Care Research Bristol and Weston Biomedical Research Centre, Surgical Innovation Theme, Centre for Surgical Research, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-3354-3330
Chris A RogersClinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-9624-2615
At Bristol · GBUniversity of Bristol · GBHarefield Hospital · GBNational Institute for Health Research · GBCastle Hill Hospital · GBEdinburgh Royal Infirmary · GBJames Cook University Hospital · GBJohn Radcliffe Hospital · GBUniversity Hospitals Bristol NHS Foundation Trust · GBUniversity of Birmingham · GBUniversity of Liverpool · GB

Funding

British Heart FoundationDepartment of Health 13/04/03Medical Research Council MR/K025643/1
6 · The paper itself

Abstract

backgroundLung cancer is the leading cause of cancer death. Surgery remains the main method of managing early-stage disease. Minimal-access video-assisted thoracoscopic surgery results in less tissue trauma than open surgery; however, it is not known if it improves patient outcomes.

objectiveTo compare the clinical effectiveness and cost-effectiveness of video-assisted thoracoscopic surgery lobectomy with open surgery for the treatment of lung cancer. DESIGN, SETTING AND

participantsA multicentre, superiority, parallel-group, randomised controlled trial with blinding of participants (until hospital discharge) and outcome assessors conducted in nine NHS hospitals. Adults referred for lung resection for known or suspected lung cancer, with disease suitable for both surgeries, were eligible. Participants were followed up for 1 year.

interventionsParticipants were randomised 1 : 1 to video-assisted thoracoscopic surgery lobectomy or open surgery. Video-assisted thoracoscopic surgery used one to four keyhole incisions without rib spreading. Open surgery used a single incision with rib spreading, with or without rib resection.

main outcome measuresThe primary outcome was self-reported physical function (using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30) at 5 weeks. Secondary outcomes included upstaging to pathologic node stage 2 disease, time from surgery to hospital discharge, pain in the first 2 days, prolonged pain requiring analgesia at > 5 weeks, adverse health events, uptake of adjuvant treatment, overall and disease-free survival, quality of life (Quality of Life Questionnaire Core 30, Quality of Life Questionnaire Lung Cancer 13 and EQ-5D) at 2 and 5 weeks and 3, 6 and 12 months, and cost-effectiveness.

resultsA total of 503 patients were randomised between July 2015 and February 2019 (video-assisted thoracoscopic surgery, LIMITATIONS: Ethnic minorities were under-represented compared with the UK population (< 5%), but the cohort reflected the lung cancer population.

conclusionsVideo-assisted thoracoscopic surgery lobectomy was associated with less pain, fewer complications and better quality of life without any compromise to oncologic outcome. Use of video-assisted thoracoscopic surgery is highly likely to be cost-effective for the NHS. FUTURE WORK: Evaluation of the efficacy of video-assisted thoracoscopic surgery with robotic assistance, which is being offered in many hospitals.

trial registrationThis trial is registered as ISRCTN13472721.

fundingThis project was funded by the National Institute for Health and Care Research ( NIHR ) Health Technology Assessment programme and will be published in full in

Indexed as

Lung NeoplasmsThoracic Surgery, Video-AssistedAdultAgedCost-Benefit AnalysisFemaleHumansMalePainQuality of LifeSelf ReportANALGESIABIOPSYCARDIOTHORACIC SURGERYCOST-BENEFIT ANALYSISDISEASE-FREE SURVIVALDISEASE PROGRESSIONFROZEN SECTIONSINFORMED CONSENTINTENTION TO TREAT ANALYSISLENGTH OF STAYLOBECTOMYLUNG CANCERMINIMALLY INVASIVEONCOLOGYOPEN SURGERYPAINPAIN MEASUREMENTPATIENT REPORTED OUTCOME MEASURESQUALITY-ADJUSTED LIFE YEARSQUALITY OF LIFERANDOMISED CONTROLLED TRIALRESPIRATORY MEDICINESURGERYSURVEYS AND QUESTIONNAIRESTHORACIC SURGERYTHORACOTOMYVATS LOBECTOMYVIDEO ASSISTEDVIDEO-ASSISTED

Identifiers

PMID36524582
PMCPMC9791462
OpenAlexW4311891569

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.