Extended Sleeve Lobectomy is an Alternative for Centrally Located Lung Cancer With Superior Short- and Long-term Outcomes

Wang, Xing; Jiang, Siming; You, Xiaofang; Aramini, Beatrice; Shabaturov, Leonid; Jiang, Gening; Zhu, Yuming; Jiang, Fan

doi:10.1016/j.cllc.2020.12.002

Cited by 6 publications

(9 citation statements)

References 23 publications

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“…Sleeve lobectomy is an optional surgical procedure to improve postoperative quality of life compared with pneumonectomy for centrally located NSCLC, but it remains challenging, especially via VATS ( 30 ). Yang et al reported that sleeve lobectomy achieved superior perioperative outcomes and equivalent oncological efficacies compared with pneumonectomy ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of perioperative outcomes among non-small cell lung cancer patients with neoadjuvant immune checkpoint inhibitor plus chemotherapy, EGFR-TKI, and chemotherapy alone: a real-world evidence study

Zhao¹,

Xu²,

Wu³

et al. 2022

Transl Lung Cancer Res

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Background: The utilization of neoadjuvant immune checkpoint inhibitor (ICI) plus chemotherapy has increased significantly for resectable non-small cell lung cancer (NSCLC). It is still unclear whether such a treatment paradigm affects perioperative outcomes compared with other neoadjuvant treatment. We aimed to evaluate the perioperative outcomes of pulmonary resection after neoadjuvant ICI plus chemotherapy and to compare them with neoadjuvant epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKI) and neoadjuvant chemotherapy alone for resectable NSCLC.Methods: A retrospective cohort including 194 stage IB-IIIB NSCLC underwent surgical resection after neoadjuvant treatment between 2018 and 2020 were reviewed. Perioperative complications were evaluated using the Common Terminology Criteria for Adverse Events, and were compared using one-way analysis of variance for continuous variables and Pearson chi-square test.Results: There were 42, 54, and 98 patients in the neoadjuvant ICI plus chemotherapy, EGFR-TKI, and chemotherapy alone groups, respectively. The tumor size before neoadjuvant treatment was well balanced among the three groups (P=0.122). A shorter median surgical time was observed in the EGFR-TKI group than ICI plus chemotherapy group and chemotherapy group alone (120 vs. 150 vs. 146 min, P=0.041). Videoassisted thoracoscopic surgery was performed in 37 (88.1%), 49 (90.7%), and 57 (58.7%) patients in the three groups, respectively (P<0.001). A higher incidence of pneumonia (P=0.014) was found in the chemotherapy group. Perioperative mortality was observed in 1 patient (2.4%) in the ICI plus chemotherapy group and in 3 patients (3.1%) in the chemotherapy alone group (P=0.440). Patients in the ICI plus chemotherapy group had higher proportions of pathological complete response (40.5% vs. 11.1% vs. 6.1%, P<0.001) and downstaging of clinical N2 status (68.6% vs. 42.9% vs. 31.7%, P=0.012) than patients in EGFR-TKI group and chemotherapy alone group.Conclusions: Surgical resection for NSCLC following neoadjuvant ICI plus chemotherapy was safe and feasible, the perioperative outcomes were similar with neoadjuvant EGFR-TKI and chemotherapy alone without unexpected perioperative complications. Additional prospective studies are necessary to validate our findings.

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Section: Discussionmentioning

confidence: 99%

Comparison of perioperative outcomes among non-small cell lung cancer patients with neoadjuvant immune checkpoint inhibitor plus chemotherapy, EGFR-TKI, and chemotherapy alone: a real-world evidence study

Zhao¹,

Xu²,

Wu³

et al. 2022

Transl Lung Cancer Res

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“…The characteristics of the incorporated studies are demonstrated in Table 1. From the 126 articles that were retrieved originally, nine studies [4,[10][11][12][13][14][15][16][17] were included in the qualitative and seven in the quantitative analysis [10][11][12][13][14][15][16]. The level of agreement between the reviewers was "almost perfect" (kappa = 0.844; 95% CI: 0.672, 1.000).…”

Section: Search Strategy and Patient Demographicsmentioning

confidence: 99%

“…The level of agreement between the reviewers was "almost perfect" (kappa = 0.844; 95% CI: 0.672, 1.000). In addition, the study design was prospective in four studies [10,12,15,16] and retrospective in five studies [4,11,13,14,17]. Moreover, the incorporated studies were conducted in Japan [4,11,13,17], France [10], Italy [12,15], Korea [14], and China [16], and were published between 1999 and 2022.…”

Section: Search Strategy and Patient Demographicsmentioning

confidence: 99%

“…In addition, the study design was prospective in four studies [10,12,15,16] and retrospective in five studies [4,11,13,14,17]. Moreover, the incorporated studies were conducted in Japan [4,11,13,17], France [10], Italy [12,15], Korea [14], and China [16], and were published between 1999 and 2022. The ESL and PN patient populations ranged from 15 to 63 and from 15 to 76 patients, respectively.…”

Section: Search Strategy and Patient Demographicsmentioning

confidence: 99%

“…The total study population was 431 patients; 259 patients underwent ESL and 172 patients underwent PN. The Okada classification was implemented in two studies [4,15] and the modified Okada classification in six studies [10,11,13,14,16,17]. There was one study [12] that did not classify the procedures.…”

Section: Search Strategy and Patient Demographicsmentioning

confidence: 99%

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Long-Term Survival after Extended Sleeve Lobectomy (ESL) for Central Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis with Reconstructed Time-to-Event Data

Magouliotis

Zotos

Karamolegkou

et al. 2022

JCM

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Objective: We conducted a thorough literature search on patients with central non-small cell lung cancer (NSCLC) undergoing either extended sleeve lobectomy (ESL) or pneumonectomy (PN). Methods: We identified all original research studies that compared the long-term survival of ESL versus PN from 1990 to 2022. The primary endpoints were the median overall survival (OS) and disease-free survival (DFS). Complications, operative mortality, and the reoperation rate were the secondary endpoints. Regarding the primary endpoints, independent patient data were extracted from the included studies, and pooled Kaplan–Meier curves were constructed. A sensitivity analysis was performed using the leave-one-out method. Results: Nine studies were included in the qualitative and seven in the quantitative synthesis, including 431 patients. Patients in the ESL group demonstrated a significantly higher OS compared with the PN group (HR, 0.63; 95% CI, 0.46–0.87; p = 0.005). In addition, patients undergoing ESL presented a significantly higher DFS compared to the PN group (HR, 0.57; 95% CI, 0.40–0.80; p = 0.004). These findings were further validated with a sensitivity analysis. The most common complications in the ESL group were bronchopleural fistula (4.6%), stricture (3.1%), prolonged air leakage (7.3%), sputum retention (4.6%), pneumonia (7.7%), and pulmonary vein thrombosis (1.5%). ESL was associated with a low reoperation rate (1.5%) and operative mortality (1.2%). Conclusions: The present meta-analysis indicates that ESL is associated with enhanced survival outcomes compared to PN for patients with central NSCLC. Further randomized controlled trials are necessary to validate our findings.

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Clinicopathological features and surgical outcomes of lobectomy combined with segmentectomy: a cohort study

Nakazawa¹,

Shimizu²,

Yazawa³

et al. 2023

J Thorac Dis

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Background: Segmentectomy is a standard procedure, and there is considerable data on routine segmentectomies. However, there are only few reports on lobectomy performed in combination with segmentectomy (lobectomy + segmentectomy). Thus, we aimed to clarify the clinicopathological features and surgical outcomes of lobectomy + segmentectomy. Methods:We reviewed patients who underwent lobectomy + segmentectomy between January 2010 and

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Extended Sleeve Lobectomy is an Alternative for Centrally Located Lung Cancer With Superior Short- and Long-term Outcomes

Cited by 6 publications

References 23 publications

Comparison of perioperative outcomes among non-small cell lung cancer patients with neoadjuvant immune checkpoint inhibitor plus chemotherapy, EGFR-TKI, and chemotherapy alone: a real-world evidence study

Comparison of perioperative outcomes among non-small cell lung cancer patients with neoadjuvant immune checkpoint inhibitor plus chemotherapy, EGFR-TKI, and chemotherapy alone: a real-world evidence study

Long-Term Survival after Extended Sleeve Lobectomy (ESL) for Central Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis with Reconstructed Time-to-Event Data

Clinicopathological features and surgical outcomes of lobectomy combined with segmentectomy: a cohort study

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