Neoadjuvant therapy does not increase postoperative morbidity of sleeve lobectomy in locally advanced non-small cell lung cancer
Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved..
OBJECTIVES: To evaluate the feasibility and safety of sleeve lobectomy after neoadjuvant therapy by assessing the postoperative morbidity.
METHODS: Patients who underwent sleeve lobectomy for non-small cell lung cancer (NSCLC) were retrospectively analyzed from January 2018 to December 2021. A total of 613 patients were enrolled, including 124 patients who received previous neoadjuvant therapy and 489 patients who did not. Propensity score matching was adopted to create a balanced cohort consisting of 97 paired cases. Patient demographics and perioperative outcomes were compared between the 2 groups, and logistic regression analysis was used to identify risk factors for postoperative complications.
RESULTS: In the entire cohort, univariable logistic regression analysis showed that smoking history (odds ratio [OR], 1.501; 95% confidence interval [CI], 1.011-2.229, P = .044), open thoracotomy (OR, 1.748; 95% CI, 1.178-2.593, P = .006), and operation time more than 150 minutes (OR, 1.548; 95% CI, 1.029-2.328, P = .036) were risk factors for postoperative complications, and multivariable logistic regression analysis showed open thoracotomy was an independent risk factor (OR, 1.765; 95% CI, 1.178-2.643, P = .006). In the balanced cohort, the neoadjuvant group had a lower proportion of double-sleeve resections (3.1% vs 11.3%, P = .035) and longer postoperative chest tube drainage (6.67 ± 3.81 vs 5.13 ± 3.74 days, P < .001). However, no significant differences were observed in postoperative morbidity between the 2 groups (25.8% vs 24.7%, P = .869). The complete pathologic response of chemoimmunotherapy was significantly superior to chemotherapy alone (28.2% vs 4.1%, P < .001), and no significant differences were noted in postoperative morbidity in different neoadjuvant therapy modalities.
CONCLUSIONS: After neoadjuvant therapy, sleeve lobectomy can be safely performed with no increased postoperative morbidity.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:166 |
|---|---|
| Enthalten in: |
The Journal of thoracic and cardiovascular surgery - 166(2023), 4 vom: 15. Okt., Seite 1234-1244.e13 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Li, Xiang [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Journal Article |
|---|
| Anmerkungen: |
Date Completed 15.09.2023 Date Revised 15.09.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jtcvs.2023.03.016 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM354706004 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM354706004 | ||
| 003 | DE-627 | ||
| 005 | 20231226062807.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jtcvs.2023.03.016 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1182.xml |
| 035 | |a (DE-627)NLM354706004 | ||
| 035 | |a (NLM)36965521 | ||
| 035 | |a (PII)S0022-5223(23)00254-4 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Li, Xiang |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Neoadjuvant therapy does not increase postoperative morbidity of sleeve lobectomy in locally advanced non-small cell lung cancer |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 15.09.2023 | ||
| 500 | |a Date Revised 15.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: To evaluate the feasibility and safety of sleeve lobectomy after neoadjuvant therapy by assessing the postoperative morbidity | ||
| 520 | |a METHODS: Patients who underwent sleeve lobectomy for non-small cell lung cancer (NSCLC) were retrospectively analyzed from January 2018 to December 2021. A total of 613 patients were enrolled, including 124 patients who received previous neoadjuvant therapy and 489 patients who did not. Propensity score matching was adopted to create a balanced cohort consisting of 97 paired cases. Patient demographics and perioperative outcomes were compared between the 2 groups, and logistic regression analysis was used to identify risk factors for postoperative complications | ||
| 520 | |a RESULTS: In the entire cohort, univariable logistic regression analysis showed that smoking history (odds ratio [OR], 1.501; 95% confidence interval [CI], 1.011-2.229, P = .044), open thoracotomy (OR, 1.748; 95% CI, 1.178-2.593, P = .006), and operation time more than 150 minutes (OR, 1.548; 95% CI, 1.029-2.328, P = .036) were risk factors for postoperative complications, and multivariable logistic regression analysis showed open thoracotomy was an independent risk factor (OR, 1.765; 95% CI, 1.178-2.643, P = .006). In the balanced cohort, the neoadjuvant group had a lower proportion of double-sleeve resections (3.1% vs 11.3%, P = .035) and longer postoperative chest tube drainage (6.67 ± 3.81 vs 5.13 ± 3.74 days, P < .001). However, no significant differences were observed in postoperative morbidity between the 2 groups (25.8% vs 24.7%, P = .869). The complete pathologic response of chemoimmunotherapy was significantly superior to chemotherapy alone (28.2% vs 4.1%, P < .001), and no significant differences were noted in postoperative morbidity in different neoadjuvant therapy modalities | ||
| 520 | |a CONCLUSIONS: After neoadjuvant therapy, sleeve lobectomy can be safely performed with no increased postoperative morbidity | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a NSCLC | |
| 650 | 4 | |a neoadjuvant therapy | |
| 650 | 4 | |a postoperative complications | |
| 650 | 4 | |a sleeve lobectomy | |
| 700 | 1 | |a Li, Qiuyuan |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Fujun |e verfasserin |4 aut | |
| 700 | 1 | |a Gao, Erji |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Lei |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Yaqiang |e verfasserin |4 aut | |
| 700 | 1 | |a Song, Xiao |e verfasserin |4 aut | |
| 700 | 1 | |a Duan, Liang |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of thoracic and cardiovascular surgery |d 1959 |g 166(2023), 4 vom: 15. Okt., Seite 1234-1244.e13 |w (DE-627)NLM000033510 |x 1097-685X |7 nnns |
| 773 | 1 | 8 | |g volume:166 |g year:2023 |g number:4 |g day:15 |g month:10 |g pages:1234-1244.e13 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jtcvs.2023.03.016 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 166 |j 2023 |e 4 |b 15 |c 10 |h 1234-1244.e13 | ||