Neoadjuvant therapy in robotic lung surgery: elevating surgical complexity without compromising outcomes

Background: Neoadjuvant therapy, particularly the combination of chemotherapy and immunotherapy, has become standard in treating locally advanced non-small cell lung cancer (NSCLC). While this approach improves pathologic responses, its effect on postoperative outcomes following robotic-assisted tho...

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Autores: Serratosa, Inés, Déniz, Carlos, Moreno, Camilo, Macía Vidueira, Iván, Rivas Doyague, Francisco, Muñoz, Ana, Paradela, Marina, Nadal, Ernest, Mosteiro, Miguel, Padrones, Susana, García, Marta, Rodríguez-Martos, Tania, Marcè, Judith, Ojanguren, Amaia
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/219643
Acceso en línea:https://hdl.handle.net/2445/219643
Access Level:acceso abierto
Palabra clave:Quimioteràpia
Càncer de pulmó
Cirurgia toràcica
Chemotherapy
Lung cancer
Thoracic surgery
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spelling Neoadjuvant therapy in robotic lung surgery: elevating surgical complexity without compromising outcomesSerratosa, InésDéniz, CarlosMoreno, CamiloMacía Vidueira, IvánRivas Doyague, FranciscoMuñoz, AnaParadela, MarinaNadal, ErnestMosteiro, MiguelPadrones, SusanaGarcía, MartaRodríguez-Martos, TaniaMarcè, JudithOjanguren, AmaiaQuimioteràpiaCàncer de pulmóCirurgia toràcicaChemotherapyLung cancerThoracic surgeryBackground: Neoadjuvant therapy, particularly the combination of chemotherapy and immunotherapy, has become standard in treating locally advanced non-small cell lung cancer (NSCLC). While this approach improves pathologic responses, its effect on postoperative outcomes following robotic-assisted thoracic surgery (RATS) is not fully characterized. Objective: This study aimed to evaluate the impact of neoadjuvant therapy on postoperative outcomes in patients undergoing RATS for NSCLC, focusing on operative time, conversion rates to open surgery, and postoperative complications. Methods: A retrospective cohort analysis was performed on patients who underwent RATS for NSCLC between February 2019 and August 2024. Propensity score matching was utilized to balance preoperative characteristics between the groups. The primary outcomes compared were operative time, conversion rates to open surgery, and postoperative complications, with statistical significance defined as p < 0.05. Results: A total of 253 patients were included in the analysis, of whom 23 received neoadjuvant therapy (either chemotherapy or chemoimmunotherapy) and 230 did not. The neoadjuvant group had significantly longer operative times (250 min vs. 221 min, p = 0.001) but there were no significant differences in conversion rates to open surgery (8.7% vs. 3.9%, p = 0.5). However, the neoadjuvant group showed a higher incidence of prolonged air leaks (>5 days) (39.13% vs. 35.21%, p < 0.001). Other parameters, such as hospital stay and chest drainage duration, showed no statistically significant differences between the groups (p = 0.860 and p = 0.760, respectively). Conclusions: These findings support the feasibility of robotic-assisted thoracic surgery following neoadjuvant therapy in NSCLC, suggesting that this approach may be safely integrated into clinical practice for selected patients. Further studies are needed to define patient selection criteria and optimize postoperative management, potentially guiding personalized treatment strategies in complex cases.MDPI2025202520242025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion11 p.application/pdfhttps://hdl.handle.net/2445/219643Articles publicats en revistes (Patologia i Terapèutica Experimental)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/https://doi.org/10.3390/cancers16233938Cancers, 2024, vol. 16, p. 1-11https://doi.org/https://doi.org/10.3390/cancers16233938cc-by (c) Serratosa, I. et al., 2024http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2196432026-05-29T05:05:01Z
dc.title.none.fl_str_mv Neoadjuvant therapy in robotic lung surgery: elevating surgical complexity without compromising outcomes
title Neoadjuvant therapy in robotic lung surgery: elevating surgical complexity without compromising outcomes
spellingShingle Neoadjuvant therapy in robotic lung surgery: elevating surgical complexity without compromising outcomes
Serratosa, Inés
Quimioteràpia
Càncer de pulmó
Cirurgia toràcica
Chemotherapy
Lung cancer
Thoracic surgery
title_short Neoadjuvant therapy in robotic lung surgery: elevating surgical complexity without compromising outcomes
title_full Neoadjuvant therapy in robotic lung surgery: elevating surgical complexity without compromising outcomes
title_fullStr Neoadjuvant therapy in robotic lung surgery: elevating surgical complexity without compromising outcomes
title_full_unstemmed Neoadjuvant therapy in robotic lung surgery: elevating surgical complexity without compromising outcomes
title_sort Neoadjuvant therapy in robotic lung surgery: elevating surgical complexity without compromising outcomes
dc.creator.none.fl_str_mv Serratosa, Inés
Déniz, Carlos
Moreno, Camilo
Macía Vidueira, Iván
Rivas Doyague, Francisco
Muñoz, Ana
Paradela, Marina
Nadal, Ernest
Mosteiro, Miguel
Padrones, Susana
García, Marta
Rodríguez-Martos, Tania
Marcè, Judith
Ojanguren, Amaia
author Serratosa, Inés
author_facet Serratosa, Inés
Déniz, Carlos
Moreno, Camilo
Macía Vidueira, Iván
Rivas Doyague, Francisco
Muñoz, Ana
Paradela, Marina
Nadal, Ernest
Mosteiro, Miguel
Padrones, Susana
García, Marta
Rodríguez-Martos, Tania
Marcè, Judith
Ojanguren, Amaia
author_role author
author2 Déniz, Carlos
Moreno, Camilo
Macía Vidueira, Iván
Rivas Doyague, Francisco
Muñoz, Ana
Paradela, Marina
Nadal, Ernest
Mosteiro, Miguel
Padrones, Susana
García, Marta
Rodríguez-Martos, Tania
Marcè, Judith
Ojanguren, Amaia
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Quimioteràpia
Càncer de pulmó
Cirurgia toràcica
Chemotherapy
Lung cancer
Thoracic surgery
topic Quimioteràpia
Càncer de pulmó
Cirurgia toràcica
Chemotherapy
Lung cancer
Thoracic surgery
description Background: Neoadjuvant therapy, particularly the combination of chemotherapy and immunotherapy, has become standard in treating locally advanced non-small cell lung cancer (NSCLC). While this approach improves pathologic responses, its effect on postoperative outcomes following robotic-assisted thoracic surgery (RATS) is not fully characterized. Objective: This study aimed to evaluate the impact of neoadjuvant therapy on postoperative outcomes in patients undergoing RATS for NSCLC, focusing on operative time, conversion rates to open surgery, and postoperative complications. Methods: A retrospective cohort analysis was performed on patients who underwent RATS for NSCLC between February 2019 and August 2024. Propensity score matching was utilized to balance preoperative characteristics between the groups. The primary outcomes compared were operative time, conversion rates to open surgery, and postoperative complications, with statistical significance defined as p < 0.05. Results: A total of 253 patients were included in the analysis, of whom 23 received neoadjuvant therapy (either chemotherapy or chemoimmunotherapy) and 230 did not. The neoadjuvant group had significantly longer operative times (250 min vs. 221 min, p = 0.001) but there were no significant differences in conversion rates to open surgery (8.7% vs. 3.9%, p = 0.5). However, the neoadjuvant group showed a higher incidence of prolonged air leaks (>5 days) (39.13% vs. 35.21%, p < 0.001). Other parameters, such as hospital stay and chest drainage duration, showed no statistically significant differences between the groups (p = 0.860 and p = 0.760, respectively). Conclusions: These findings support the feasibility of robotic-assisted thoracic surgery following neoadjuvant therapy in NSCLC, suggesting that this approach may be safely integrated into clinical practice for selected patients. Further studies are needed to define patient selection criteria and optimize postoperative management, potentially guiding personalized treatment strategies in complex cases.
publishDate 2024
dc.date.none.fl_str_mv 2024
2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/219643
url https://hdl.handle.net/2445/219643
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/https://doi.org/10.3390/cancers16233938
Cancers, 2024, vol. 16, p. 1-11
https://doi.org/https://doi.org/10.3390/cancers16233938
dc.rights.none.fl_str_mv cc-by (c) Serratosa, I. et al., 2024
http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Serratosa, I. et al., 2024
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 11 p.
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Articles publicats en revistes (Patologia i Terapèutica Experimental)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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