Objective:Segmentectomy has been shown to be comparable with lobectomy for small lung cancers; however, it is unclear the degree to which the expansion and adoption of robotics have affected the use of segmentectomy. We aim to compare the use of segmentectomies performed between adopters and nonadopters of robotic surgery. Methods:A retrospective case-control analysis was conducted using the National Cancer Database from 2010 to 2021. Sustained robotic adoption was defined as facility performance of ≥90% of lung resections robotically for 2+ consecutive years from 2016 onwards. Time periods for facilities were categorized by pretransition (<50% usage), transition (50%-90%) and posttransition (≥90%). For all facilities, the proportion of segmentectomies performed for <2 cm lung nodules was quantified along with clinical outcomes. Results:In total, 10,045 cases of lung resection across 57 facilities met inclusion criteria. National use of segmentectomy increased from 5% in 2011 to 12% in 2019-2021. The proportion of segmentectomies performed for nodules meeting criteria has increased more with sustained robotic adopters (5.5% to 12.0%) compared with control facilities (4.0% to 6.3%) (difference-in-difference = 4.3%; 95% CI, 2.6%-6.0%). There was an increase in mean lymph node harvest for segmentectomy with sustained adopters (5.1 to 11.4) compared with control facilities (6.02 vs 10.2). Conclusions:Facilities with sustained robotic adoption were more likely to have increased uptake of segmentectomy compared with control facilities. There was also an associated increase in mean lymph node sampling. With continued uptake of robotics, we expect to see greater use of segmentectomy for lung resection for nodules meeting criteria.

In this analysis, we aim to examine the outcomes of minimally invasive and open esophagectomy in patients with a BMI > 35. This is a retrospective cohort study utilizing the NSQIP Targeted Esophagectomy database from 2016 to 2023. We identified patients with a BMI > 35 who underwent minimally invasive esophagectomy (MIE) and open esophagectomy (OE) for malignancy. Primary outcome measures included morbidity, mortality, and incidence of anastomotic leak. Secondary measures included length of stay (LOS), unplanned return to OR, pneumonia, ventilator > 48 h, unplanned intubation, and SSI. 243 patients underwent MIE and 221 patients underwent OE. 30-day mortality was 2.87

Hiatal hernia repair is a common procedure performed by both general and thoracic surgeons. While prior studies have shown that emergent hiatal hernia repairs are associated with worse outcomes than elective cases, differences in outcomes by surgical specialty for emergent repairs have not been well-described. The American College of Surgeons–National Surgical Quality Improvement Program (ACS–NSQIP) database was queried for patients undergoing hiatal hernia repair from 2012 to 2024. Patients undergoing elective repair and non-primary repairs were excluded. Perioperative outcomes were compared between patients with procedures performed by general and thoracic surgeons. Multivariable logistic regression was used to evaluate differences in outcomes after adjustment for demographics, comorbidities, and preoperative risk factors. A total of 2,629 patients were identified, including 2,443 (92.9

Background:Although the prognostic value of pathologic complete response (pCR) status has varied based on neoadjuvant strategy for operable, advanced non-small cell lung cancer (NSCLC), its value after neoadjuvant chemoimmunotherapy as compared to the other strategies is unknown. We aim to investigate the long-term survival benefits in patients receiving neoadjuvant chemotherapy alone, chemoradiation, or chemoimmunotherapy for surgically resected NSCLC with pCR. Methods:A retrospective cohort review was completed utilizing the National Cancer Database from 2017-2020. Patients with cT1B-3A NSCLC who received neoadjuvant therapy prior to surgical resection, and pCR were included. Basic demographic information, short-term outcomes, and available surgical data were collected. Long-term outcomes were assessed via Kaplan-Meier analysis with log-rank tests and multivariable regression analysis. Results:We identified 584 patients between 2017 and 2020. A majority presented with clinical stage III NSCLC (64.4%, n=376) and underwent lobectomy (86.9%, n=505). A majority received chemoradiation (59.8%, n=349), followed by chemotherapy alone (25%, n=146) and chemoimmunotherapy (15.2%, n=89). There was a significant association with improved 5-year overall survival (OS) in patients who achieved PCR status between chemoimmunotherapy (84.4%) and chemoradiation (70%) (P<0.05). There was no significant difference in OS between neoadjuvant chemoimmunotherapy (84.4%) vs. chemotherapy alone (82%) (P=0.65). Conclusions:In patients with NSCLC with pCR, there was a significantly greater association of OS in patients who received neoadjuvant chemoimmunotherapy compared to those who received chemoradiation. There was no significant survival difference between chemoimmunotherapy and chemotherapy alone.

Background:There is significant value in predicting and better assessing patients who are at risk of post-surgery upstaging in lung cancer. The objective of this study is to review patients who were upstaged following resection and evaluate their clinical and demographic data to elucidate which factors portend an increased risk of pathologic upstaging at our institution (the Thomas Jefferson University Hospital). Methods:A retrospective review of institutional data was performed between 2011 and 2023. Patients with stage I-II non-small cell lung cancer (NSCLC) were included. Patients were excluded if they received neoadjuvant systemic therapy, including chemotherapy and/or immunotherapy, and were excluded if they received pre-operative mediastinoscopy or endobronchial ultrasound (EBUS). Kaplan-Meier analysis was utilized with log-rank testing to examine 5-year overall survival and progression-free survival. A logistic regression model was built to evaluate whether certain clinical or demographic factors affect the odds of being upstaged. Results:A total of 371 patients met the inclusion criteria. Male sex, primary tumor standardized uptake value (SUV) >8, pre-operative biopsy, and having 10-13 lymph nodes explored were all associated with increased odds of being upstaged. Squamous cell histology was associated with lower odds of upstaging compared to adenocarcinoma. Patients who had their tumor detected via a screening computed tomography (CT) scan had a trend towards a decreased odds of upstaging compared to symptomatic and incidentally found tumors. Conclusions:Male gender, primary tumor SUV >8, having a preoperative biopsy, and having 10-13 lymph nodes explored were associated with increased odds of being upstaged. This analysis provides patients and clinicians with valuable data regarding upstaging early-stage lung cancers, which could be used to guide multidisciplinary teams in making more informed decisions regarding resection and the use of perioperative systemic therapy.

Importance:Current lung cancer guidelines recommend lymph node sampling (LNS) with the 3 + 1 rule, which recommends station-based sampling with at least 3 N2 (mediastinal) and 1 N1 (hilar) nodal stations. Although there is oncologic benefit to rigorous LNS, potential negative impacts on surgical outcomes have not been well investigated. As adoption of the 3 + 1 rule increases given its formalization as guideline-concordant care, associations with adverse outcomes are crucial to characterize. Objective:To evaluate whether satisfying the 3 + 1 rule is associated with increased postoperative complications. Design, Setting, and Participants:This retrospective cohort study used the Society of Thoracic Surgeons General Thoracic Database, which was queried for patients with clinical stage T1 to T3, N0, M0 non-small cell lung cancer (NSCLC) who underwent surgical resection with known LNS between July 1, 2021, and January 1, 2023. Statistical analysis was performed from March 2024 to March 2025. Exposure:A propensity match was conducted to compare the postoperative complication rate by 3 + 1 LNS status. Main Outcomes and Measures:Data on demographic characteristics were collected and analyzed. Primary outcomes included postoperative complications, such as arrhythmias, pleural effusion requiring drainage, blood transfusion, prolonged air leak, therapeutic bronchoscopy, pneumonia, respiratory failure, bronchopleural fistula, pulmonary embolism, pneumothorax, prolonged ventilatory support, myocardial infarction, and sepsis. Thirty-day mortality and readmission rates were also evaluated. Results:The cohort included 28 439 patients (median [IQR] age, 69 [66-75] years; 4791 [59.5%] female). There were 18 939 patients (66.6%) who satisfied the 3 + 1 rule. In the unadjusted group, the 3 + 1 cohort had longer median (IQR) operating room duration (224 [178-281] vs 210 [161-273] minutes, P < .001) and rates of pathologic upstaging (2520 [13.3%] vs 922 [9.7%], P < .001). In the postmatch analysis, there were no other significant differences in postoperative complication rates, and the aforementioned associations in the 3 + 1 group were no longer observed. Conclusions and Relevance:In this cohort study of patients with NSCLC, the 3 + 1 rule was not associated with increased postoperative complications. This study's findings suggest support for the continued use of this strategy in terms of overall safety profile.

BACKGROUND:The adoption of the robotic platform in thoracic surgery has increased within the last decade. We aim to compare clinical outcomes among facilities that performed lung resections for patients with non-small lung cancer (NSCLC) preadoption and postadoption of robotic surgery. METHODS:A retrospective case-control analysis was conducted using the National Cancer Database from 2010 through 2021. Facilities that performed ≥90% of robotic lung resections for at least 2 consecutive years in 2016 or afterward were deemed sustained adopters. Time periods for facilities were categorized by pretransition (<50% use), transition (50%-90%), and posttransition (≥90%). Primary (30- and 90-day mortality) and secondary outcomes (30-day readmission, robot-to-open conversion, margin positivity, mean lymph nodes sampled, and pathological upstaging) were analyzed preadoption and postadoption. RESULTS:Within our cohort, 57 facilities met criteria with 24,909 cases. Of these, 12,181 occurred in the pretransition period (robotic use [RU], 8.6%), 7440 in the transition period (RU, 79.6%), and 5288 in the posttransition period (RU, 93.6%). Compared with control facilities, a greater proportion of study facilities experienced decreases in 30-day (70% vs 63.2%) and 90-day mortality (72.5% vs 52.6%) posttransition. A smaller proportion of study facilities showed decreases in mean lymph nodes sampled (17.5% vs 38.2%) and pathologic upstaging (23.2% vs 40.7%) compared with control facilities. CONCLUSIONS:Facilities that sustained adopted robotic surgery may be associated with decreased short-term mortality rates and higher rates of lymph nodes sampled and pathologic upstaging. Continued uptake of robotic platforms in thoracic surgery is not only safe but may also provide mortality and oncologic benefit.

PURPOSE Lung cancer screening (LCS) is one of the most potentially impactful interventions of the past two decades for reducing lung cancer mortality. However, no current standard exists in the field for comprehensive data collection and tracking of LCS, despite availability of electronic health records (EHRs) and LCS management tools. In a widely expanding LCS program, harmonization of data becomes critical for decisions surrounding clinical care coordination and operational management. METHODS This article summarizes the implementation of an integrated, digital framework within the Jefferson Health System using the Epic EHR and its customized SmartForms as well as Research Electronic Data Capture application. Leveraging these tools has allowed for standardized documentation across the LCS process continuum for each patient: LCS eligibility, shared decision making, low-dose computed tomography, and follow-up. RESULTS Since the initial rollout in October 2022, 11 program sites across four regional hubs have adopted this framework. A standardized process paired with interoperability between systems has resulted in a centralized data repository, increased communication and transparency within and between program sites, and decreased duplicative or manual processes across the entire LCS program. CONCLUSION The resultant digital framework is poised for scale-up and sustainment across the Jefferson Health System, and it can also be replicated across other LCS programs. Future iterations of the current work or adoption by other programs should take into account the complexities of the EHR itself and data provenance to ensure success. Active participation among stakeholders for synchronous coordination of building, implementing, and troubleshooting a comprehensive repository for LCS data can ultimately facilitate measurement of quality metrics and develop future research in early detection of lung cancer.

Background Recent studies have shown a high-quality wedge resection to be equivalent to lobectomy for small, early-stage non-small cell lung cancer (NSCLC). High-quality wedge resections include compliance with 3+1 lymph node sampling (LNS). We aimed to evaluate whether robotic-assisted wedges are more likely to comply with 3+1 LNS. Methods The Society of Thoracic Surgeons General Thoracic Database was queried for patients with clinical T1 N0 M0 NSCLC who underwent wedge resection with LNS between July 2021 and January 2023. Multivariable regression was used to examine factors associated with 3+1 LNS. Results A total of 4162 patients were identified; 1815 (43.6%) underwent 3+1 LNS. Patients in the 3+1 LNS group were less likely to undergo open operations (4.6% vs 6.0%) or video-assisted thoracoscopic surgery (VATS) (40.2% vs 60.8%) (P < .001). The robotic approach had the largest association with compliance (vs VATS; odds ratio, 2.53; 95% CI, 2.22-2.90; P < .001). Conclusions Less than one-half of patients with early-stage NSCLC who were treated with wedge resection satisfied 3+1 LNS. Patients who underwent robotic-assisted wedge resection were 2.5 times more likely to undergo guideline-concordant LNS. The robotic approach was the most significant factor in achieving 3+1 LNS.

BACKGROUND:Although there are well-studied sex and racial/ethnic disparities within lung cancer patients, they do not examine the interface of these inequities. We aim to utilize a national database to evaluate clinical outcomes and disparities within racial/ethnic groups of female patients with early-stage lung cancer. METHODS:The 2020 National Cancer Database (NCDB) was queried for patients with clinical stage I non-small cell lung cancer (NSCLC) with known vital status between 2010 and 2019. Patients with carcinoid tumors were excluded. Demographic data, clinicopathologic variables, 30-d, 90-d, 5-y mortality, and 5-y overall survival were analyzed. RESULTS:A total of 344,223 patients met the inclusion criteria, of which 187,588 were female (54.4%). Within ethnic subgroups, 5-y survival was highest among Asian/Pacific Islander women (API) (77.8%) (P < 0.001). API women had the highest rates of surgical resection (75.7%), with higher rates of nodes examined (73.1%) and nodal upstaging (13.4%) (P < 0.001). Black and White women had the lowest rates of 5-y survival (60%, 58.8%) and surgical resection (59.1%, 62.2%) (P < 0.001). API women had the least comorbidities (CCI = 0, 71.1%; P < 0.001) and highest rates of well-differentiated tumors (28.7%, P < 0.001). CONCLUSIONS:API women had the highest survival rates, highest rates of surgical resection with nodal sampling, and low-grade tumors. Black and White women had the lowest rates of overall survival and surgical resection. This disparity in guideline-concordant surgery highlights the importance of acknowledging the racial/ethnic heterogeneity among women with early-stage NSCLC and that female lung cancer patients should not be treated as a monolith.

BACKGROUND:With the robotic approach to Ivor Lewis esophagectomy gaining popularity, concern has been raised regarding a learning curve resulting in increased complication rates. This study aimed to present the results of a standardized health system approach to Ivor Lewis esophagectomy and the transition to the robotic-assisted technique. METHODS:A retrospective review of our institutional database, along with individual patient chart review, was conducted. Patients who underwent Ivor Lewis esophagectomy at our institution from June 1, 2017, to July 7, 2023, were included. Preoperative patient characteristics and operative outcomes were recorded. The outcomes of the 60 most recent laparoscopic/thoracoscopic minimally invasive esophagectomies (MIEs) were compared with those of the first 60 robotic-assisted esophagectomies (RAMIEs). RESULTS:Over the study period, 145 patients were included for review. Of the Ivor Lewis esophagectomies, 5 were performed open, 80 were performed laparoscopic/thoracoscopic, and 60 were performed robotic assisted. The length of stay ranged from 5 to 84 days, with a median of 7 days. Leak from the esophagogastric anastomosis occurred in 5 cases (3.4%). Pulmonary complications occurred in 21 cases (14.5%). There were no 90-day mortality events. In the subset analysis, there was an increased mean operative time in the RAMIE group (443 vs 504 min [95% CI, -88.1 to -34.2]), but there were no significant differences in perioperative outcomes between the MIE and RAMIE groups. CONCLUSION:A standardized approach to perioperative management and operative technique can allow for low morbidity and mortality after Ivor Lewis esophagectomy and facilitate transitioning to a robotic-assisted technique without increasing complications.

Medicaid expansion under the Affordable Care Act aimed to expand healthcare access, improve quality, and reduce costs. The effects of Medicaid expansion on receipt of local therapy for lung cancer are unknown. We utilized the National Cancer Database to conduct a retrospective analysis of patients with clinical T1-2, N0, M0 non-small cell lung cancer (NSCLC) without neoadjuvant treatment. Patients living in Medicaid expansion states as of January 2014 were compared with patients in non-expansion states between 2010 and 2013 (pre-expansion) and 2016 and 2019 (post-expansion). A difference-in-difference (DID) analysis was used to compare rates of surgery and stereotactic body radiation therapy (SBRT). Among 149,966 patients, there were 80,514 patients (53.6

Background There is a discussion amongst oncologic societies regarding the necessity of preoperative biopsy prior to resection in lung cancer. We aim to examine outcomes of segmentectomy with or without preoperative biopsy in non-small cell lung cancer (NSCLC) patients. Methods A retrospective cohort study was conducted utilizing the National Cancer Database. Adult patients diagnosed with clinical stage I (N0 M0, tumor size ≤ 2 cm) NSCLC between 2010-2019 who underwent segmentectomy were included. Patients with carcinoid tumors or who received neoadjuvant systemic or radiation therapy were excluded. Demographic and clinical variables were analyzed. Propensity score matching (PSM) was performed to adjust for confounders between patients who underwent segmentectomy with versus without preoperative biopsy. Short term outcomes (readmission, 30-day and 90-day survival) and long-term overall survival (OS) were compared between groups. Results In total, 6,891 patients met inclusion criteria, of which 2,287 (33.2%) underwent preoperative biopsy and 4,604 (66.8%) did not. There was no significant difference in 30-day readmission (P = .13), 30-day survival (P = .26), and 90-day survival (P = .31). Patients who did not receive preoperative biopsy was associated with a higher 5-year OS (P = .02); however, post-PSM, there was no significant difference between the two groups (P = .20). Conclusions After PSM, no significant difference was found in margin positivity, nodal upstaging, 30-day readmission, 30- and 90-day survival, and 5-year OS between cohorts. This demonstrates that segmentectomy without preoperative biopsy remains a safe option for those with early stage, ≤ 2 cm NSCLC. MicroAbstract Limited data 2exist on the safety of diagnostic segmentectomy. Using a national sample of patients with segmentectomy with or without preoperative biopsy, no significant difference was found in margin positivity, nodal upstaging, readmission and survival between cohorts. This demonstrates that segmentectomy without preoperative biopsy remains a safe option for those with early stage, ≤ 2 cm NSCLC.

Background: Segmentectomy has proven to be a safe and effective option for early-stage non-small cell lung cancer (NSCLC). Our objective is to compare quality of resection between robotic video-assisted thoracoscopic surgery (RVATS) and video-assisted thoracoscopic segmentectomy (VATS). We hypothesize that robotic segmentectomy will allow for a more complete oncologic resection. Methods: This retrospective cohort study utilized the National Cancer Database. We examined patients >18 years old who underwent a robotic or VATS segmentectomy for clinical N0M0, <= 2 cm NSCLC between 2010-2020. Quality of oncologic resection was assessed through presence of nodes examined, number of nodes examined, margin positivity, upstaging, and extent of upstaging. Outcome variables including 30-day mortality, 90-day mortality and readmission rates were analyzed. Kaplan-Meier curves were used to compare 5-year overall survival (OS) between the two cohorts. Propensity score matching (PSM) was utilized to further compare outcomes between groups. Results: A total of 5,369 patients were examined. Of these patients, 1,891 underwent RVATS segmentectomy, and 3,478 VATS. The mean age of the cohort was 69 years (P=0.47). The mean tumor size was 1.4 cm in both cohorts (P=0.81). Most patients were treated at academic facilities (50.1%, P<0.001). Pre-PSM, VATS patients had a smaller number of regional nodes examined compared to RVATS (7 vs. 8, P<0.001). VATS patients were also more likely to have no nodes examined (9.9% vs. 5.1%, P<0.001). Nodal upstaging occurred more frequently in the RVATS cohort (4.3% vs. 3.0%, P=0.02). There were no statistically significant differences between 30-day mortality, 90-day mortality, readmission and receipt of adjuvant therapy between cohorts. Post PSM, there were an equal number of nodes examined between cohorts (P=0.12). There continued to be more nodal upstaging in the RVATS cohort (P=0.03). There were again no significant differences between 30-day mortality, 90-day mortality, readmission, and receipt of adjuvant therapy. There were comparable 5-year OS rates between cohorts (76.4% RVATS vs. 77.7% VATS), which remained true post matching. Conclusions: RVATS segmentectomy is associated with a higher number of nodes examined and higher rates of nodal upstaging when compared to VATS. Though some of these differences normalize on further analysis there is a suggestion that RVATS may be associated with a greater nodal yield.

Objective To determine which metrics are reliable to define episodes of care and differentiate healthcare performance in the management of suspected early-stage lung cancer. Research Design A retrospective cohort study was completed utilizing data from the healthcare cost and utilization project to identify patients with a lung nodule in 2018 who underwent an intervention by the end of 2019. This study included hospitals in Florida, Maryland, and Pennsylvania. Ambulatory interventions included bronchoscopic interventions, image-guided biopsy, stereotactic body radiation therapy, chemotherapy, any biopsy intervention, and multiple biopsy interventions. The reliability of each risk-adjusted utilization and inpatient metric was calculated using mixed effects logistic regression. Results A total of 7446 patients were identified across 368 hospitals. The median reliability for the risk-adjusted utilization at the hospital level for bronchoscopic interventions was 0.67 (Interquartile Range (IQR) 0–0.9), for image-guided biopsy was 0.68 (IQR 0–0.91), and for any biopsy procedure was 0.78 (IQR 0–0.94). The proportion of hospitals reaching the established reliability benchmark of 0.7 for utilization of a bronchoscopic intervention, image-guided biopsy, and any biopsy procedure was 45.6 %, 49.2 %, and 55.4 %, respectively. Median reliability was found to be zero for chemotherapy, stereotactic body radiation therapy, and multiple biopsy procedures. Conclusions Utilization of bronchoscopic interventions, image-guided biopsy, and any biopsy procedure in the management of suspected early-stage lung cancer met common reliability benchmarks for some hospitals. Understanding which metrics are reliable may influence inclusion in designing episodes of care to comprehensively differentiate hospital performance.

Limited data 2exist on the safety of diagnostic segmentectomy. Using a national sample of patients with segmentectomy with or without preoperative biopsy, no significant difference was found in margin positivity, nodal upstaging, readmission and survival between cohorts. This demonstrates that segmentectomy without preoperative biopsy remains a safe option for those with early stage, <= 2 cm NSCLC. Background: There is a discussion amongst oncologic societies regarding the necessity of preoperative biopsy prior to resection in lung cancer. We aim to examine outcomes of segmentectomy with or without preoperative biopsy in nonsmall cell lung cancer (NSCLC) patients. Methods: A retrospective cohort study was conducted utilizing the National Cancer Database. Adult patients diagnosed with clinical stage I (N0 M0, tumor size <= 2 cm) NSCLC between 2010 and 2019 who underwent segmentectomy were included. Patients with carcinoid tumors or who received neoadjuvant systemic or radiation therapy were excluded. Demographic and clinical variables were analyzed. Propensity score matching (PSM) was performed to adjust for confounders between patients who underwent segmentectomy with versus without preoperative biopsy. Short term outcomes (readmission, 30-day and 90-day survival) and long-term overall survival (OS) were compared between groups. Results: In total, 6891 patients met inclusion criteria, of which 2287 (33.2%) underwent preoperative biopsy and 4604 (66.8%) did not. There was no significant difference in 30-day readmission (P = .13), 30-day survival (P = .26), and 90-day survival (P = .31). Patients who did not receive preoperative biopsy was associated with a higher 5-year OS (P = .02); however, post-PSM, there was no significant difference between the 2 groups (P = .20). Conclusions: After PSM, no significant difference was found in margin positivity, nodal upstaging, 30-day readmission, 30- and 90-day survival, and 5-year OS between cohorts. This demonstrates that segmentectomy without preoperative biopsy remains a safe option for those with early stage, <= 2 cm NSCLC. (c) 2025 Published by Elsevier Inc.

Background:Traditionally, lung and chest wall (CW) resections were performed via an open approach for non-small cell lung cancer (NSCLC) with CW involvement. Our objective is to examine the outcomes of patients with NSCLC and CW involvement resected through a minimally invasive (MIS) [video-assisted thoracoscopic surgery (VATS) or robotic] approach. Methods:This is a retrospective cohort study of the 2021 National Cancer Database (NCDB). We examined patients >18 years who underwent MIS or open lung and CW resection for clinically N0M0 NSCLC between 2010 and 2020. Outcomes studied include 30-, 90-day mortality, and readmission. Additionally, the number of nodes examined, margins, and rate of nodal upstaging were analyzed. Results:A total of 1,370 patients treated with an open resection and 352 patients treated with a MIS approach were examined. The average age at diagnosis was 66 years. The average primary tumor size was 4.75 cm (3.2-6.5 cm) in the MIS cohort and 5.7 cm (4.2-7.3 cm) in the open cohort. There was a significant difference in 30-day mortality between cohorts (P=0.002). There were no significant differences in other outcome measures (90-day mortality, readmission). There was no significant difference in margin positivity or nodal upstaging. There were more overall nodes examined in the MIS cohort (14 vs. 11, P<0.001). There were no significant differences in the 5-year overall survival (OS) between cohorts. Post-propensity score matching outcomes yielded similar significance to the unmatched cohort. Conclusions:This study suggests that MIS lung and CW resection is associated with similar short and long-term outcomes in most measures as compared to open surgery.