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Updated: Mar 22, 2026
Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
Video-assisted thoracoscopic surgery lobectomy for lung cancer versus thoracotomy: a less decrease in sVEGFR2 level
Jun Peng1, Su An1, Hui-Ping Wang1
11 Department of Thoracic Surgery, The First People's Hospital of Yunnan Province, Kunming University of Science and Technology, Kunming 650032, China ; 2 Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China ; 3 Children's Hospital Affiliated to Kunming Medical University, Kunming 650228, China.
Background:
Angiogenic and anti-angiogenic factors play an important role in tumor biology and tumor recurrence after surgical resection. Antiangiogenic factors such as vascular endothelial growth factor (VEGF)-receptor 1 (sVEGFR1) and sVEGFR2, two soluble form receptor proteins of VEGF, are critical for angiogenesis. VEGF can be sequestered by soluble forms of these receptors, which result in decreasing VEGF amount available to bind to its receptor on vascular endothelial cell surface. This study aimed to investigate the influences of video-assisted thoracoscopic surgery (VATS) lobectomy and open by thoracotomy for early stage non-small cell lung cancer (NSCLC) on postoperative circulating sVEGFR1 and sVEGFR2 levels.
Methods:
Forty-eight lung cancer patients underwent lobectomy through either VATS (n=26) or thoracotomy (n=22). Blood samples were collected from all patients preoperatively and postoperatively on days 1, 3 and 7. ELISA analysis was used to determine the plasma levels of sVEGFR1 and sVEGFR2. Data are reported as means and standard deviations, and were assessed with the Wilcoxon signed-Rank test (P<0.05).
Results:
For all patients undergoing lobectomy, postoperative sVEGFR1 levels on days 1 and 3 were markedly increased, while postoperative sVEGFR2 levels on days 1 and 3 were significantly decreased. Moreover, VATS group had significantly higher plasma level of sVEGFR2 postoperative in comparison with open thoracotomy (OT) on day 1 (VATS 6,953±1,535 pg/mL; OT 5,874±1,328 pg/mL, P<0.05).
Conclusions:
Major pulmonary resection for early stage NSCLC resulted in the increased sVEGFR1 and decreased sVEGFR2 productions. VATS is associated with enhanced anti-angiogenic response with higher circulating sVEGFR2 levels compared with that with OT. Such differences in anti-angiogenic response may have an important effect on cancer biology and recurrence after surgery.
Insights
Video-assisted thoracoscopic surgery (VATS) lobectomy for lung cancer increases soluble vascular endothelial growth factor (VEGF) receptor 2 (sVEGFR2) levels more than open thoracotomy. This enhanced anti-angiogenic response may impact cancer recurrence.
Area of Science:
- Oncology
- Thoracic Surgery
- Molecular Biology
Background:
- Angiogenic and anti-angiogenic factors are crucial in tumor biology and recurrence.
- Soluble vascular endothelial growth factor (VEGF) receptors, sVEGFR1 and sVEGFR2, regulate angiogenesis by sequestering VEGF.
- Surgical resection for non-small cell lung cancer (NSCLC) can influence these angiogenic factors.
Purpose of the Study:
- To compare the impact of video-assisted thoracoscopic surgery (VATS) lobectomy versus open thoracotomy (OT) on postoperative circulating sVEGFR1 and sVEGFR2 levels in early-stage NSCLC patients.
- To investigate the role of surgical approach in modulating the anti-angiogenic response post-pulmonary resection.
Main Methods:
- A cohort of 48 early-stage NSCLC patients underwent either VATS (n=26) or OT (n=22) lobectomy.
- Plasma levels of sVEGFR1 and sVEGFR2 were measured using ELISA preoperatively and on postoperative days 1, 3, and 7.
- Statistical analysis was performed using the Wilcoxon signed-Rank test.
Main Results:
- Postoperative sVEGFR1 levels increased on days 1 and 3, while sVEGFR2 levels decreased on days 1 and 3 in all lobectomy patients.
- Patients undergoing VATS demonstrated significantly higher plasma sVEGFR2 levels on postoperative day 1 compared to those who underwent OT (VATS: 6,953±1,535 pg/mL vs. OT: 5,874±1,328 pg/mL, P<0.05).
Conclusions:
- Major pulmonary resection for NSCLC alters the balance of angiogenic factors, increasing sVEGFR1 and decreasing sVEGFR2.
- VATS lobectomy is associated with a stronger anti-angiogenic response, evidenced by higher postoperative sVEGFR2 levels compared to OT.
- These differences in anti-angiogenic profiles may influence lung cancer biology and postoperative recurrence rates.
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