2023 World Conference on Lung Cancer (Posters)-EP08.02. Neoadjuvant Therapy, Still a Contraindication to VATS Lobectomy or is it a New Indication?

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This study aimed to evaluate the feasibility, safety, and outcomes of video-assisted thoracoscopy (VATS) in patients with non-small cell lung cancer (NSCLC) who received neoadjuvant therapy (NT). VATS has become the preferred surgical technique for resectable early-stage NSCLC due to its faster recovery, lower pain, and aesthetically pleasing results. However, VATS is considered a relative contraindication in patients who have received neoadjuvant therapy traditionally. This study aimed to assess whether neoadjuvant therapy could increase the frequency of VATS application by reducing tumor stage and diameter.<br /><br />The data of patients who underwent VATS lung resection and lymph node dissection for NSCLC between 2011 and 2021 were analyzed. The patients were divided into two groups: Group 1 included patients who did not receive oncological treatment before surgery, and Group 2 included patients who received neoadjuvant treatment before surgery. Surgical details, postoperative complications, and pathological stages were compared between the two groups.<br /><br />A total of 306 patients were included in the study, with Group 1 comprising 236 patients and Group 2 comprising 70 patients. Complications were observed in 33% of patients after surgery, with no significant difference between the two groups. Mortality was detected in 1.6% of patients, again with no significant difference between the groups. The mean operation time was slightly longer in Group 2. Conversion to thoracotomy occurred in 17% of Group 1 patients and 25% of Group 2 patients. Distant metastasis and local recurrence were observed in both groups, with a slightly higher prevalence in Group 2.<br /><br />The results of this study suggest that VATS can be safely performed in patients who have received neoadjuvant therapy, with similar oncological outcomes. Neoadjuvant therapy may also decrease tumor size and increase the frequency of VATS application. Thus, neoadjuvant therapy could be considered a new indication for VATS in NSCLC patients. Further research is needed to confirm these findings and explore the potential benefits of neoadjuvant therapy in VATS procedures.

Asset Subtitle

Cengiz Gebitekin

Meta Tag

Speaker Cengiz Gebitekin

Topic Local-Regional NSCLC: Multimodality Therapy

Keywords

video-assisted thoracoscopy

VATS

non-small cell lung cancer

NSCLC

neoadjuvant therapy

feasibility

safety

oncological treatment

tumor stage

surgical technique