En Bloc Resection in NSCLC Feasibility and Outcomes

Non-small-cell lung cancer (NSCLC) is a common type of lung cancer often treated with surgical resection. While conventional surgery involves separating the affected lobe and lymph nodes, en bloc surgery is a novel technique that removes them as a single unit.

Toshiyuki Nagata and the team aimed to compare en bloc surgery with conventional surgery in terms of surgical outcomes and survival rates in patients with NSCLC.

The study retrospectively reviewed patients who underwent lobectomy and lymph node dissection for stages I-III NSCLC. Using propensity score-matching to minimize bias, researchers compared 317 pairs of patients who underwent either en bloc or conventional surgery. The primary outcomes were surgical parameters (operation time, blood loss, postoperative complications) and survival rates.

The results demonstrated that en bloc surgery was not associated with increased operative time, blood loss, or postoperative complications compared to conventional surgery. While the number of resected lymph nodes and the rate of N upstaging were comparable between groups, en bloc surgery was linked to a statistically significant improvement in overall survival (OS) (P= 0.012). This survival advantage was particularly notable in patients with pathologically confirmed N-positive disease (P= 0.005), but not in those with N-negative disease.

The study suggested that en bloc surgery is a safe and feasible technique for patients with resectable NSCLC, potentially offering a survival benefit, especially in cases of N-positive disease. Further research is warranted to confirm these findings and determine the optimal patient population for this surgical approach.

No funding information was given.

Source: https://pubmed.ncbi.nlm.nih.gov/39231734/

Nagata T, Aoki M, Maeda K, et al. (2024). ‘En Bloc Resection of a Primary Tumor and Lymph Nodes in Non-Small-Cell Lung Cancer.” Ann Thorac Cardiovasc Surg. 2024;30(1):10.5761/atcs.oa.24-00108. doi:10.5761/atcs.oa.24-00108