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Updated: May 26, 2026

Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
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Sleeve lobectomy after induction chemoradiotherapy.

Abel Gómez-Caro1, Marc Boada, Noemí Reguart

  • 1General Thoracic Surgery Department, University of Barcelona, Barcelona, Spain. gomezcar@clinic.ub.es

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 7, 2012
PubMed
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Neoadjuvant chemoradiotherapy (CRT) before sleeve lobectomy (SL) does not increase surgical complications or mortality. However, long-term survival is lower in patients receiving CRT, despite a complete mediastinal response indicating better prognosis.

Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Neoadjuvant Therapy

Background:

  • The impact of induction chemoradiotherapy (CRT) on bronchial anastomoses after sleeve lobectomy (SL) is not well-defined.
  • Assessing outcomes of neoadjuvant CRT in SL is crucial for treatment planning.

Purpose of the Study:

  • To evaluate the effect of neoadjuvant CRT on mortality, morbidity, and survival in patients undergoing SL.
  • To determine if complete mediastinal response after neoadjuvant CRT influences survival outcomes.

Main Methods:

  • Prospective study including patients undergoing SL from June 2005 to December 2010.
  • Collected data on clinico-demographic variables, comorbidities, pulmonary function, SL type, complications, neoadjuvant CRT, and mortality.
  • Compared outcomes between patients who received neoadjuvant CRT and those who did not.

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Main Results:

  • No significant difference in complication rates between non-CRT and CRT groups (33% vs. 37%).
  • Overall 5-year survival was significantly lower in the CRT group (33%) compared to the non-CRT group (69%).
  • Complete mediastinal pathological response after CRT was associated with significantly worse survival (43%) compared to the non-CRT group (69%).

Conclusions:

  • Neoadjuvant CRT does not increase surgical morbidity, anastomotic complications, or mortality in SL.
  • Complete mediastinal response is a significant prognostic factor for better survival, but overall survival remains lower after induction CRT.
  • SL following neoadjuvant CRT is safe and reliable, offering an alternative to pneumonectomy for central tumors.