WCLC 2025 - Posters & ePosters-EP.07.21 The Efficacy of the ‘Lung Partial Resection Prior to Lobectomy Method’ as a No-Touch Isolation Technique in Lung Cancer Surgery

EP.07.21 The Efficacy of the ‘Lung Partial Resection Prior to Lobectomy Method’ as a No-Touch Isolation Technique in Lung Cancer Surgery

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The study conducted by Yokohama City University and 24 other Japanese institutions evaluated the prognostic efficacy of the “lung partial resection prior to lobectomy method” as a no-touch isolation technique (NTIT) in patients with clinical stage IA-IB non-small-cell lung cancer (NSCLC). NTIT aims to prevent the intraoperative release of circulating tumor cells (CTCs) caused by surgical manipulation, which can worsen prognosis.<br /><br />This multicenter retrospective observational study analyzed 1,583 patients who underwent lobectomy with mediastinal lymph node dissection between 2017 and 2018, excluding those with neoadjuvant therapy or missing data. Patients were divided into Group P (partial resection prior to lobectomy, n=410) and Group N (normal lobectomy, n=1,173). Propensity score matching (PSM) was applied to reduce bias, matching 282 pairs based on 17 clinical and pathological factors.<br /><br />Results showed that Group P had significantly better 3-year recurrence-free survival (RFS) than Group N both before (90.6% vs. 80.4%, p=0.001) and after PSM (90.3% vs. 84.9%, p=0.046). The cumulative incidence of postoperative recurrence was also lower in Group P, with no difference in death from other diseases. Subset analysis revealed that the benefit was significant in patients without lymph node metastasis (pN0) but not in those with nodal involvement (pN1-2), consistent with the NTIT concept that controlling CTC release is more effective in early-stage disease without nodal spread. <br /><br />This study is the first large-scale report demonstrating the efficacy of lung partial resection prior to lobectomy as an NTIT in NSCLC surgery, offering an easier alternative to the vein-first lobectomy method. Limitations include the retrospective design and imbalance in EGFR mutation status post-PSM. Prospective randomized controlled trials are warranted to confirm these findings.<br /><br />In conclusion, lung partial resection prior to lobectomy may effectively reduce intraoperative CTC release, improving recurrence-free survival in early-stage NSCLC patients without lymph node metastases.

Asset Subtitle

Hiroyuki Adachi

Meta Tag

Speaker Hiroyuki Adachi

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

lung partial resection

lobectomy

non-small-cell lung cancer

NSCLC

no-touch isolation technique

NTIT

circulating tumor cells

CTCs

recurrence-free survival

propensity score matching