2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.06G.12 The Fibrosis Around the Pulmonary Artery Is Associated with Difficulty in Dissection During Surgery after Systemic Therapy

EP.06G.12 The Fibrosis Around the Pulmonary Artery Is Associated with Difficulty in Dissection During Surgery after Systemic Therapy

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The study, conducted by Mitsue Kawahara and colleagues at the Cancer Institute Hospital of JFCR in Tokyo, explores the challenges posed by fibrosis around the pulmonary artery during surgeries following systemic therapy for lung cancer. Systemic cancer treatment often induces proliferative fibrosis in large vessels and airways near the tumor bed, complicating surgical dissection.<br /><br />The study included six patients who underwent anatomical lung resection following systemic therapy, with tumors or enlarged hilar lymph nodes near the pulmonary artery before treatment. During surgery, the fibrous layer's thickness and media around the pulmonary artery were measured, focusing on the side not in contact with the bronchus.<br /><br />Results varied by case with different therapies and outcomes, highlighting that fibrosis was often associated with difficulty in dissection of the pulmonary artery. For instance, difficult dissections were noted in cases involving therapies like pembrolizumab and crizotinib, while easier dissections were observed with treatments like alectinib and brigatinib. These variations suggest that certain therapies might contribute more significantly to fibrotic changes, complicating surgical procedures.<br /><br />The findings underscore a significant correlation between systemic therapy-induced fibrosis and complications in pulmonary artery dissection during lung surgery. The study concludes that further research is essential to understand better the mechanisms of fibrosis development in the tumor bed and improve pre-operative radiological assessments to predict fibrous layer thickening. Addressing these challenges may enhance surgical outcomes and patient safety by anticipating difficulties in dissection and adjusting surgical planning accordingly.

Asset Subtitle

Mitsue Kawahara

Meta Tag

Speaker Mitsue Kawahara

Topic Pathology and Biomarkers

Keywords

fibrosis

pulmonary artery

systemic therapy

lung cancer

surgical dissection

tumor bed

pembrolizumab

crizotinib

alectinib

brigatinib