Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 7;2(3):453-457.
doi: 10.1016/j.atssr.2024.02.008. eCollection 2024 Sep.

Institutional Experience With Robotic Lobectomy After Neoadjuvant Immunotherapy and Chemotherapy

Shale J Mack  1 , Hamza Rshaidat  1   2 , Annie Ho  1 , Brian M Till  1   2 , Micaela L Collins  1   2 , Gregory L Whitehorn  1 , Jonathan Martin  1 , John D Jacob  1   2 , Tyler R Grenda  1   2 , Nathaniel R Evans 3rd  1   2 , Olugbenga T Okusanya  1   2
Affiliations

Institutional Experience With Robotic Lobectomy After Neoadjuvant Immunotherapy and Chemotherapy

Shale J Mack et al. Ann Thorac Surg Short Rep. .

Abstract

Background: The real-world safety of robotic resections after neoadjuvant chemoimmunotherapy remains poorly defined in patients with non-small cell lung cancer. Due to reported increased operative challenges after neoadjuvant immunotherapy, we aim to describe our early institutional experience and outcomes after robotic resection in this clinical context.

Methods: We performed a retrospective chart review of patients with non-small cell lung cancer who underwent a robotic lobectomy, comparing patients from June 1, 2022, through October 31, 2023, who were treated with neoadjuvant chemoimmunotherapy consistent with the Checkmate-816 protocol and a control group with upfront resection.

Results: A total of 21 patients underwent neoadjuvant chemoimmunotherapy and robotic lobectomy in our cohort, and 64 patients were in the control group. Compared with control, the median tumor size was 3.2 cm vs 2.0 cm (P = .001). The most common clinical stage was IIIA (11 patients, 52%) in the neoadjuvant chemoimmunotherapy group and IA2 in the control group (26 patients, 45%) (P < .001). Operative time was greater in the neoadjuvant chemoimmunotherapy group (224 vs 177 minutes, P = .011). The median quantity of lymph nodes resected in the neoadjuvant chemoimmunotherapy group was greater (21 vs 16.5, P = .042). A R0 resection was achieved in all cases and no conversions to an open lobectomy occurred. Postoperative length of stay was 2 days in both groups (P = .92), and there were similar rates of postoperative air leak (33% vs 48%, P = .23) and acute post-hemorrhagic anemia (19% vs 14%, P = .58).

Conclusions: In our cohort, robotic-assisted lobectomy was safe and of comparable quality in the setting of neoadjuvant chemoimmunotherapy.

PubMed Disclaimer

Figures

None
Graphical abstract
See this image and copyright information in PMC

References

    1. Chaft J.E., Hellmann M.D., Velez M.J., Travis W.D., Rusch V.W. Initial experience with lung cancer resection after treatment with T-cell checkpoint inhibitors. Ann Thorac Surg. 2017;104:e217–e218. doi: 10.1016/j.athoracsur.2017.03.038. - DOI - PMC - PubMed
    1. Uprety D., Mandrekar S.J., Wigle D., et al. Neoadjuvant immunotherapy for NSCLC: current concepts and future approaches. J Thorac Oncol. 2020;15:1281–1297. doi: 10.1016/j.jtho.2020.05.020. - DOI - PubMed
    1. Bott M.J., Yang S.C., Park B.J., et al. Initial results of pulmonary resection after neoadjuvant nivolumab in patients with resectable non-small cell lung cancer. J Thorac Cardiovasc Surg. 2019;158:269–276. doi: 10.1016/j.jtcvs2018.11.124. - DOI - PMC - PubMed
    1. Forde P.M., Spicer J., Lu S., et al. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med. 2022;386:1973–1985. doi: 10.1056/NEJMoa2202170. - DOI - PMC - PubMed
    1. Lee J.M., Tsuboi M., Brunelli A. Surgical perspective on neoadjuvant immunotherapy in non-small cell lung cancer. Ann Thorac Surg. 2022;114:1505–1515. doi: 10.1016/j.athoracsur.2021.06.069. - DOI - PubMed

LinkOut - more resources