Association between different sequences of vessel ligation during video-assisted thoracoscopic lobectomy and survival in patients with non-small cell lung cancer

He, Huang-He; He, Jiaxi; Hao, Zhexue; Wang, Wei

doi:10.21037/jtd.2019.02.69

Cited by 13 publications

(21 citation statements)

References 18 publications

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“…In lung cancer surgery, VFL might suppress the release of CTCs, and clinical observation studies have shown that VFL helps reduce recurrence [5][6][7]. However, contrasting ndings have also been reported [8][9][10][11]. A recent study by Wei et.…”

Section: Discussionmentioning

confidence: 99%

Does Vein-first Lobectomy Control Postoperative Circulating Tumor Cells in Lung Cancer?: a Retrospective Observational Study

Sawabata

Nakane

Yoshikawa

et al. 2021

Preprint

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Background: Vein-first dissecting lobectomy in lung cancer surgery is speculated to limit the amount of circulating tumor cells. We aimed to assess the clinical significance and prognostic impact of Vein-first dissecting lobectomy according to changes in circulating tumor cell status throughout the perioperative period.Methods: Among patients with pulmonary nodule who underwent surgery, we extracted and evaluated patients who underwent lobectomy for lung cancer and had underwent circulating tumor cell testing before and immediately after the completion of lobectomy. The primary evaluation item was the detection rate of postoperative circulating tumor cell according to the sequence of pulmonary vessel processing. The secondary evaluation items were the 2-year recurrence-free survival and overall survival rates according to the status of Vein-first dissecting lobectomy and postoperative circulating tumor cell. Results: Between June 2014 and June 2018, 302 patients with pulmonary nodule underwent surgery, among them we selected 86 patients who underwent lobectomy for lung cancer and had circulating tumor cell testing done before and immediately after the completion of lobectomy. The circulating tumor cell identification rates in the postoperative period were 54.4% (37/68) and 66.7% (12/18) (p=0.8) in vein-first dissecting lobectomy group and no-vein-first dissecting lobectomy group, respectively. The mean postoperative circulating tumor cell count was not significantly different between the vein-first dissecting lobectomy and no-vein-first dissecting lobectomy groups (3.0 ± 3.6 vs 3.2 ± 5.0, p=0.8). The 2-year recurrence-free survival and overall survival rates were also not significantly different. However, the presence of circulating tumor cell after surgery was a predictor of recurrence.Conclusions: Although the detection of circulating tumor cell after surgery is a predictor of cancer recurrence, no significant difference was observed in the status of postoperative circulating tumor cell s between vein-first dissecting lobectomy and no- vein-first dissecting lobectomy groups in lung cancer surgery.

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Section: Discussionmentioning

confidence: 99%

Does Vein-first Lobectomy Control Postoperative Circulating Tumor Cells in Lung Cancer?: a Retrospective Observational Study

Sawabata

Nakane

Yoshikawa

et al. 2021

Preprint

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“…Refaely et al (22) also demonstrated that that the sequence of vessel interruption was not a risk factor for recurrence. He et al (23) reported that the sequence of pulmonary vessel ligation during video-assisted thoracoscopic surgery lobectomy for NSCLC had no significant effects on overall survival and recurrence-free survival. Therefore, ligating the PA-first remains an option during lobectomy based on the preference of the surgeon or the minimally invasive surgery technique used, particularly for upper lobectomy (21).…”

Section: Discussionmentioning

confidence: 99%

Wedge Resection of Tumor Before Lobectomy for Lung Cancer Could Be a No-touch Isolation Technique

Yasukawa

Sawabata

Kawaguchi

et al. 2020

In Vivo

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Background/Aim: Circulating tumor cells (CTCs) can be a surrogate biomarker of prospective prognosis. Surgical manipulation can promote the dissemination of CTCs. Prognosis improvement is expected with the no-touch isolation technique (NTIT), preventing surgical manipulation. The Wedge resection of the tumor site before lobectomy could prevent surgical manipulation during lobectomy for nonsmall cell lung cancer (NSCLC) and reduce the shedding of tumor cells, similar to a NTIT. This study aimed to evaluate the effect of wedge resection technique. Patients and Methods: A total of 624 resected NSCLC patients were retrospectively analyzed. Patients were divided in two groups: Wedge and Non-Wedge. Overall survival (OS) curves were plotted using the Kaplan-Meier method. Results: The 5-year OS rates were 89.9% and 84.0% in the Wedge and Non-Wedge groups, respectively (p=0.033). Conclusion: The OS in the Wedge group was significantly better than that in the Non-Wedge group. Wedge resection technique for NSCLC may be a NTIT.779 resection compared to non-wedge resection before lobectomy for NSCLC patients. The aim of this study was to evaluate the effect of wedge resection of the tumor site before lobectomy as a no-touch isolation technique. This is the first study to investigate the efficacy of wedge resection during lobectomy for NSCLC. Yasukawa et al: Effect of Wedge Resection of Tumor for NSCLC

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“…Refaely et al (27) have also demonstrated that the sequence of vessel interruption was not a risk factor for recurrence. He et al (28) have reported that the sequence of pulmonary vessel ligation during VATS lobectomy for NSCLC has no different effects on overall survival and recurrence-free survival.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Intraoperative Pulmonary Wedge Resection of Tumor Site Before Lobectomy for Early Lung Adenocarcinoma

et al. 2019

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Background/Aim: Circulating tumor cells (CTCs) are tumor cells shed from tumor sites and circulate in the peripheral blood. CTCs can be a surrogate biomarker of recurrence and prognosis. Because surgical manipulation could promote CTCs, it is important to reduce CTCs during surgery. This study aimed to evaluate the effectiveness of intraoperative wedge resection of the tumor site before lobectomy. Patients and Methods: A total of 297 resected stage I lung adenocarcinoma patients were retrospectively reviewed. Patients were divided into two groups: Wedge and Non-Wedge. Recurrence-free survival (RFS) curves were plotted using the Kaplan-Meier method. Cox regression analyses were used to evaluate the hazard ratio (HR) with the endpoint RFS. Results: The 5-year RFS rates were 92.9% and 85.5%, in Wedge and Non-Wedge groups, respectively (p=0.006). Wedge resection was an independent factor associated with RFS (HR=0.342, 95%CI=0.141-0.830, p=0.018). Conclusion: Wedge resection before lobectomy for lung adenocarcinoma patients can improve RFS rates.

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Association between different sequences of vessel ligation during video-assisted thoracoscopic lobectomy and survival in patients with non-small cell lung cancer

Cited by 13 publications

References 18 publications

Does Vein-first Lobectomy Control Postoperative Circulating Tumor Cells in Lung Cancer?: a Retrospective Observational Study

Does Vein-first Lobectomy Control Postoperative Circulating Tumor Cells in Lung Cancer?: a Retrospective Observational Study

Wedge Resection of Tumor Before Lobectomy for Lung Cancer Could Be a No-touch Isolation Technique

Effectiveness of Intraoperative Pulmonary Wedge Resection of Tumor Site Before Lobectomy for Early Lung Adenocarcinoma

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