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Thoracoscopic Lobectomy after Neoadjuvant Chemoradiation
Sahil Dayal, James Speicher
Brody School of Medicine at East Carolina University, Greenville, NC, USA

OBJECTIVE: Non-small cell lung cancer remains the most common cause of neoplastic mortality in the United States. Preoperative chemoradiation therapy (CRT) increases the complexity of surgical resection, resulting in slow adoption of minimally invasive techniques for post-neoadjuvant resection. The aim of our study was to demonstrate that there was no difference in surgical outcomes when performing minimally invasive thoracoscopic lobectomy after neoadjuvant CRT.
METHODS: A 275 patient database who underwent lobectomy between the years 2014 and 2019 at a single institution was conducted. Statistical analysis (ANOVA, chi square) of continuous and categorical data (refer to Table 1) was performed to compare outcomes of patients undergoing thoracoscopic lobectomy with history of neoadjuvant CRT, chemotherapy only, and radiation only to those with no CRT.
RESULTS: There were significant differences only between the groups for the demographic categories of preoperative DCLO, smoking history, and current smoking status, and also lower rates of post-op pulmonary complications in the radiation only group. See Table 1 for p values and other data.
CONCLUSIONS: There were no significant differences found in surgical outcomes for thoracoscopic lobectomy after neoadjuvant therapies when compared to patients who went directly to surgery, except for a lower rate of pulmonary complications seen in radiation only patients, which may be attributable to selection bias, sample size, or the lower rate of current smokers in the radiation only group. The data indicates that thoracoscopic lobectomy after neoadjuvant CRT is a safe option for patients with advanced regional non-small cell lung cancer.


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