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. 2024 Dec 25;40(1):ivae191.
doi: 10.1093/icvts/ivae191.

Impact of neoadjuvant therapy on angioplastic lobectomy: a retrospective study

Tayeb Benkiran  1   2 , Kheira Hireche  3 , Sebastien Frey  2   4 , Adeline Morisot  5 , Aude Nguyen  3 , Quentin Rudondy  1   2 , Florent Alcaraz  1   2 , Mauro Guarino  1   2 , Charlotte Cohen  1 , Abel Gomez-Caro  1 , Jean-Phillippe Berthet  1   2
Affiliations

Impact of neoadjuvant therapy on angioplastic lobectomy: a retrospective study

Tayeb Benkiran et al. Interdiscip Cardiovasc Thorac Surg. .

Abstract

Objectives: The efficacy of neoadjuvant therapy (NT) prior to angioplastic lobectomy (AL) in non-small cell lung cancer is unclear. This study assessed its impact on morbidity, mortality and 5-year survival.

Methods: We retrospectively analysed 114 patients who underwent AL at 2 tertiary centres from January 2000 to December 2020. Comparisons were made between patients who received NT and those who did not.

Results: Among the patients, 78 (68.4%) underwent upfront surgery, and 36 (31.6%) received NT. There were no significant differences in postoperative complications (46.2% vs 31.6%, P = 0.42) or mortality rates (0% vs 3.8%, P = 0.55). Pathological upstaging differed significantly (37.2% vs 5.6%, P = 0.0008). Five-year survival rates were comparable (54% vs 38%, P = 0.3).

Conclusions: Neoadjuvant therapy does not adversely affect morbidity, arterial repair complications or mortality in AL. There are no survival differences at 5 years. AL remains a safe option following NT.

Keywords: Lung cancer: combined treatment modalities; Lung cancer: surgical therapy.

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Figures

None
Graphical abstract
Figure 1:
Figure 1:
Different types of arterial reconstructions. (A) Tangential angioplasty; (B) patch angioplasty; (C) direct end-to-end anastomosis; and (D) conduit replacement.
Figure 2:
Figure 2:
Flow chart.
Figure 3:
Figure 3:
Comparison of overall survival between the neoadjuvant (NT + curve) and the non-neoadjuvant therapy (Nt - curve) groups. The 5-year overall survival rates in the non-neoadjuvant therapy and neoadjuvant therapy groups were 54% (95% confidence interval 0.41–0.71) and 38% (95% confidence interval 0.16–0.91), respectively (P = 0.3). There was no significant difference between the 2 groups.
Figure 4:
Figure 4:
Comparison of overall event-free survival between neoadjuvant therapy (NT + curve) and non-neoadjuvant therapy (NT - curve) groups. The 5-year event-free survival rates in the non-neoadjuvant therapy and the neoadjuvant therapy groups were not statistically different, with 36% (95% confidence interval 0.25–0.51) and 23% (95% confidence interval 0.08–0.58), respectively (P = 0.1).
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