2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-PP02.44

PP02.44 - Haifeng Shen

Pdf Summary

This retrospective study examines the feasibility and safety of minimally invasive sleeve lobectomy in patients with locally advanced non-small cell lung cancer (NSCLC) who received neoadjuvant therapy. Conducted at the Second Affiliated Hospital of Zhejiang University from 2014 to 2023, the study involved 56 patients with NSCLC, primarily of the squamous cell carcinoma type (85.7%). Predominantly male (96.4%), participants had undergone different types of lobectomies: right upper lobe (26 patients), left upper lobe (14), and left lower lobe (11).<br /><br />The study assessed the outcomes of those who received various neoadjuvant therapies: 28 patients had chemo-immunotherapy, 21 had chemotherapy alone, and 7 had a combination of targeted therapy and chemotherapy. Pre-treatment TNM staging varied, with most at stage III (34 patients), while post-therapy stages showed improvement with cases predominantly shifting to stages 0, I, and II.<br /><br />Of the surgeries performed, 75% were via uniportal video-assisted thoracoscopic surgery, and 23.2% through robotic-assisted technology. The conversion rate to open surgery was low at 3.6%. On average, surgery lasted 3.4 hours, with an intraoperative blood loss of 111.4 mL and drainage duration of 6 days. Lymph node dissection was thorough, with an average of 25.7 nodes examined, and the negative surgical margin rate was 98.2%. Pathologic complete response was achieved in 19.6% of cases.<br /><br />17 patients experienced perioperative complications, including 1 mortality. Post-surgery, 91.1% of patients received adjuvant therapy. The median follow-up time was 25.5 months, showing 1-year and 3-year overall survival rates of 94.5% and 78.0%, and progression-free survival rates of 82.4% and 67.6%, respectively.<br /><br />The study concludes that minimally invasive sleeve lobectomy is a feasible and safe option when conducted in experienced centers, and it enables radical resection of locally advanced NSCLC following induction therapies.

Keywords

minimally invasive sleeve lobectomy

non-small cell lung cancer

neoadjuvant therapy

uniportal video-assisted thoracoscopic surgery

robotic-assisted surgery

squamous cell carcinoma

chemo-immunotherapy

TNM staging

lymph node dissection

pathologic complete response