2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-PP02.24

PP02.24 - Xiang Li

Pdf Summary

This study, conducted by Xiang Li and colleagues at the Shanghai Pulmonary Hospital, explored the outcomes of sleeve lobectomy (SL) versus pneumonectomy (PN) in patients with locally advanced non-small cell lung cancer (NSCLC) following neoadjuvant therapy. Lung cancer is a leading cause of cancer deaths, and most NSCLC cases are diagnosed at advanced stages, necessitating surgery and comprehensive treatment. Neoadjuvant therapy aims to shrink tumors, making previously inoperable cases operable and allowing for less invasive surgical options.<br /><br />The study retrospectively analyzed patients from 2018 to 2021 who underwent either SL or PN. It particularly focused on those who could potentially transition from PN to SL after neoadjuvant treatment, which includes chemotherapy, immunotherapy, targeted therapy, and radiotherapy. The results demonstrated that SL patients had better 3-year disease-free survival (DFS) and overall survival (OS) rates than those who underwent PN (DFS 74.2% vs. 58.4%; OS 80.6% vs. 62.3%).<br /><br />Moreover, neoadjuvant chemoimmunotherapy showed improved pathological responses compared to chemotherapy alone. Perioperative outcomes indicated that SL was associated with longer operation times but necessitated fewer postoperative transfusions and had fewer severe complications compared to PN. Importantly, the study showed that 57 patients initially eligible only for PN could undergo SL after neoadjuvant therapy.<br /><br />The findings suggest that SL offers superior long-term survival outcomes and fewer complications than PN for locally advanced NSCLC following neoadjuvant therapy. This research supports the feasibility of converting PN candidates to SL, highlighting the potential for less invasive surgery when anatomical criteria are met, ultimately improving patient survival and quality of life.

Keywords

sleeve lobectomy

pneumonectomy

non-small cell lung cancer

neoadjuvant therapy

disease-free survival

overall survival

chemoimmunotherapy

pathological responses

perioperative outcomes

Shanghai Pulmonary Hospital