Surgery for Superior Sulcus Tumor, Partially Using a Robotic Approach, After Neoadjuvant Nivolumab With...

Area of Science:

• Thoracic oncology
• Surgical innovation
• Immunotherapy

Background:

• Superior sulcus tumors traditionally treated with chemoradiotherapy and surgery.
• Radiation-induced fibrosis complicates surgical resection.
• Neoadjuvant nivolumab plus chemotherapy shows improved prognosis and fewer surgical complications.

Purpose of the Study:

• To report a case of superior sulcus tumor managed with neoadjuvant immunochemotherapy and a hybrid surgical approach.
• To evaluate the feasibility and outcomes of robotic-assisted surgery in this context.

Main Methods:

• A hybrid surgical approach combining an L-shaped incision for chest wall resection.
• Robotic-assisted left upper lobectomy and lymphadenectomy.
• Preoperative treatment with neoadjuvant nivolumab and platinum-based chemotherapy.

Main Results:

• Successful surgical resection of the superior sulcus tumor was achieved.
• The patient experienced a major pathologic response.
• The recovery was uneventful, with limited perioperative complications.

Conclusions:

• Neoadjuvant immunochemotherapy followed by robotic-assisted surgery is a viable strategy for superior sulcus tumors.
• This combined approach can optimize patient outcomes and surgical management.
• Further research is warranted to validate these findings in larger cohorts.