WCLC 2025 - Posters & ePosters-P2.08 .57 Small Volume Segmental Lung Autotransplantation for Treatment of Central Lung Cancer:One Case Report

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This case report presents the innovative use of small-volume segmental lung autotransplantation for treating central non-small cell lung cancer (NSCLC), addressing the limitations of traditional surgical options and improving lung function preservation. Central lung tumors often require extensive resections like pneumonectomy, which carry high mortality risks. Conventional sleeve resections, while lung-sparing, are insufficient for 15-20% of advanced cases, especially in patients with limited pulmonary reserve where neoadjuvant therapies fail or cause toxicity.<br /><br />The authors describe a 67-year-old male with a large left hilar squamous cell carcinoma (12x10x9 cm) invading critical bronchovascular structures. After six cycles of neoadjuvant chemoimmunotherapy, the tumor size showed slight reduction. Given the tumor location and the patient’s functional status, they performed small-volume segmental autotransplantation by resecting preserved left S910 segments and reconstructing bronchovascular connections in situ. The technique entailed left upper lobectomy with S78 segmentectomy, followed by vascular and airway anastomosis using precise end-to-end suturing, achieving wider resection margins (1.5 cm) than conventional sleeve resections.<br /><br />Postoperatively, the patient recovered well with no ischemic or anastomotic complications. Bronchoscopy and CT imaging confirmed no stenosis or tumor recurrence at 9 months, underscoring the procedure’s functional and oncologic success. Advantages of the in situ autotransplant approach include minimized warm ischemia (30 minutes), elimination of complex ex situ graft preparation, and preserved graft vascularity. Rigorous postoperative care—daily bronchoscopic clearance, balanced anticoagulation, and perfusion monitoring—was integral to optimizing outcomes.<br /><br />This novel surgical modality offers a reproducible, lung-preserving alternative to pneumonectomy for select central NSCLC cases requiring complex resections. While early results are promising, further studies with larger cohorts and long-term follow-up are necessary to validate oncologic efficacy and expand indications. The report advances a paradigm shift in managing difficult central lung cancers by harmonizing radical tumor control with maximal pulmonary function preservation.

Asset Subtitle

Jinbao Xie

Meta Tag

Speaker Jinbao Xie

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

small-volume segmental lung autotransplantation

central non-small cell lung cancer

NSCLC

lung function preservation

pneumonectomy alternatives

sleeve resection limitations

bronchovascular reconstruction

neoadjuvant chemoimmunotherapy

postoperative outcomes

lung-preserving surgery