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Impact of pulmonary vein-first ligation during lobectomy on the postoperative survival and recurrence rates in patients with non-small cell lung cancer: a multicenter propensity score-matched study

  • 0Department of Thoracic Surgery, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
Surgery Today +

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May 30, 2024

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May 30, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Ligating the pulmonary vein first during lung cancer lobectomy significantly improves patient survival and reduces recurrence rates. This technique enhances outcomes for non-small cell lung cancer patients undergoing surgery.

Area Of Science

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background

  • Surgical manipulation during lung cancer lobectomy can increase circulating tumor cells, raising metastasis risk.
  • Optimizing surgical techniques is crucial for improving patient prognosis in lung cancer treatment.

Purpose Of The Study

  • To investigate the impact of ligating the tumor-draining pulmonary vein first during lobectomy on lung cancer patient prognosis.
  • To determine if a "vein-first" approach improves survival and recurrence rates compared to conventional methods.

Main Methods

  • Retrospective evaluation of patients undergoing curative lobectomy for solitary non-small cell lung carcinoma (2012-2016).
  • Patients were divided into a "vein-first" group (pulmonary veins ligated before artery/bronchus) and an "other procedure" group.
  • Propensity score matching was used to create comparable patient cohorts for analysis.

Main Results

  • The vein-first group demonstrated significantly better 5-year overall survival (85.6% vs. 69.4%) and recurrence-free survival (73.4% vs. 53.5%).
  • The cumulative recurrence rate at 5 years post-surgery was significantly lower in the vein-first group (21.7% vs. 38.3%).
  • These improvements were observed after propensity score matching, indicating the technique's efficacy.

Conclusions

  • Ligating the pulmonary vein first during lung cancer lobectomy is associated with improved overall survival and recurrence-free survival.
  • This surgical approach may reduce the cumulative recurrence rate in non-small cell lung cancer patients.
  • The "vein-first" technique represents a promising strategy for enhancing surgical outcomes in lung cancer treatment.

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