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<p>The technical complexity of salvage lung resection after epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitor (TKI) therapy remains unclear, in contrast to the well-recognized technical difficulty of salvage surgery after chemoradiotherapy. We retrospectively reviewed 15 patients with Stage IIIB/IV lung cancer who underwent anatomical lung resection after EGFR–TKI therapy and compared perioperative outcomes according to clinical nodal (cN) status (cN − vs. cN+). Although postoperative complication <i>rates were similar</i>, cN+ cases demonstrated greater <i>technical complexity</i>, including longer operative time (median increase, 66%), greater blood loss (median increase, 138%), and more frequently requiring bronchovascular reconstruction (30% vs. 0%). <i>These findings may warrant caution for thoracic surgeons when operating on TKI-treated patients with cN+ disease</i>, <i>even when the primary tumor appears surgically favorable.</i></p>

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Clinical nodal positive disease is associated with greater surgical complexity in salvage lung resection after tyrosine kinase inhibitor therapy

  • 期刊论文

  • 发表日期：

    2026年2月19日

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  • Shigeki Suzuki,
  • Takahiro Suzuki,
  • Yu Okubo,
  • Kyohei Masai,
  • Kaoru Kaseda,
  • Keisuke Asakura

摘要

The technical complexity of salvage lung resection after epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitor (TKI) therapy remains unclear, in contrast to the well-recognized technical difficulty of salvage surgery after chemoradiotherapy. We retrospectively reviewed 15 patients with Stage IIIB/IV lung cancer who underwent anatomical lung resection after EGFR–TKI therapy and compared perioperative outcomes according to clinical nodal (cN) status (cN − vs. cN+). Although postoperative complication rates were similar, cN+ cases demonstrated greater technical complexity, including longer operative time (median increase, 66%), greater blood loss (median increase, 138%), and more frequently requiring bronchovascular reconstruction (30% vs. 0%). These findings may warrant caution for thoracic surgeons when operating on TKI-treated patients with cN+ disease, even when the primary tumor appears surgically favorable.