Safety and feasibility of robotic-assisted thoracic surgery after neoadjuvant chemoimmunotherapy in non-small cell lung cancer

Jun Zeng; Jun Zeng; Jun Zeng; Jun Zeng; Bin Yi; Bin Yi; Bin Yi; Bin Yi; Ruimin Chang; Ruimin Chang; Ruimin Chang; Ruimin Chang; Yufan Chen; Yufan Chen; Yufan Chen; Yufan Chen; Zhongjie Yu; Zhongjie Yu; Zhongjie Yu; Zhongjie Yu; Yang Gao; Yang Gao; Yang Gao; Yang Gao

doi:10.3389/fonc.2023.1134713

Frontiers in Oncology (Feb 2023)

Safety and feasibility of robotic-assisted thoracic surgery after neoadjuvant chemoimmunotherapy in non-small cell lung cancer

Jun Zeng,
Jun Zeng,
Jun Zeng,
Jun Zeng,
Bin Yi,
Bin Yi,
Bin Yi,
Bin Yi,
Ruimin Chang,
Ruimin Chang,
Ruimin Chang,
Ruimin Chang,
Yufan Chen,
Yufan Chen,
Yufan Chen,
Yufan Chen,
Zhongjie Yu,
Zhongjie Yu,
Zhongjie Yu,
Zhongjie Yu,
Yang Gao,
Yang Gao,
Yang Gao,
Yang Gao

Affiliations

Jun Zeng: Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
Jun Zeng: Hunan Engineering Research Center for Pulmonary Nodules Precise Diagnosis and Treatment, Xiangya Hospital, Central South University, Changsha, Hunan, China
Jun Zeng: National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
Jun Zeng: Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
Bin Yi: Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
Bin Yi: Hunan Engineering Research Center for Pulmonary Nodules Precise Diagnosis and Treatment, Xiangya Hospital, Central South University, Changsha, Hunan, China
Bin Yi: National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
Bin Yi: Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
Ruimin Chang: Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
Ruimin Chang: Hunan Engineering Research Center for Pulmonary Nodules Precise Diagnosis and Treatment, Xiangya Hospital, Central South University, Changsha, Hunan, China
Ruimin Chang: National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
Ruimin Chang: Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
Yufan Chen: Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
Yufan Chen: Hunan Engineering Research Center for Pulmonary Nodules Precise Diagnosis and Treatment, Xiangya Hospital, Central South University, Changsha, Hunan, China
Yufan Chen: National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
Yufan Chen: Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
Zhongjie Yu: Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
Zhongjie Yu: Hunan Engineering Research Center for Pulmonary Nodules Precise Diagnosis and Treatment, Xiangya Hospital, Central South University, Changsha, Hunan, China
Zhongjie Yu: National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
Zhongjie Yu: Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
Yang Gao: Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
Yang Gao: Hunan Engineering Research Center for Pulmonary Nodules Precise Diagnosis and Treatment, Xiangya Hospital, Central South University, Changsha, Hunan, China
Yang Gao: National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
Yang Gao: Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, Hunan, China

DOI: https://doi.org/10.3389/fonc.2023.1134713
Journal volume & issue: Vol. 13

Abstract

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ObjectivesThis study aimed to evaluate the safety and feasibility of robotic-assisted thoracic surgery (RATS) after neoadjuvant chemoimmunotherapy in NSCLC.MethodsWe retrospectively collected data for NSCLC patients who received thoracic surgery after neoadjuvant chemoimmunotherapy from May 2020 to August 2022. Surgery details, pathological response, and perioperative outcome were compared between video-assisted thoracic surgery (VATS) group and RATS group. Inverse probability of treatment weighting (IPTW) was used to equal the baseline characteristics.ResultsA total of 220 patients were divided into 78 VATS patients and 142 RATS patients. There was no 90-day mortality in either group. RATS patients demonstrated better results in conversion rate to thoracotomy (VATS vs. RATS: 28.2% vs. 7.5%, P < 0.001), number of lymph node stations harvested (5.63 ± 1.75 vs. 8.09 ± 5.73, P < 0.001), number of lymph nodes harvested (13.49 ± 9.325 vs. 20.35 ± 10.322, P < 0.001), yield pathologic-N (yp-N) assessment (yp-N0, 88.5% vs. 67.6%; yp-N1, 7.6% vs. 12.6%; yp-N2, 3.8% vs. 19.7%; P < 0.001), and visual analog scale pain score after surgery (4.41 ± 0.93 vs. 3.77 ± 1.21, P=0.002). However, there were no significant differences in pathological response evaluation for neoadjuvant chemoimmunotherapy (P = 0.493) and complication rate (P = 0.803). After IPTW-adjustment, these results remained constant.ConclusionsRATS reduced the risk of conversion to thoracotomy, provided a better yp-N stage evaluation, and improved pain score; this suggests that RATS is safe and feasible for NSCLC patients after neoadjuvant chemoimmunotherapy.

Published in Frontiers in Oncology

ISSN: 2234-943X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.frontiersin.org/journals/oncology/

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