Short term outcomes of robotic surgery after neoadjuvant treatment for locally advanced NSCLC: a comparison with the open approach

Filippo Tommaso Gallina^1*Riccardo Tajè¹Daniele Forcella¹Gabriele Alessandrini¹Francesco Vizza²Rachele Bovini³Paolo Visca¹Isabella Sperduti¹Federico Cappuzzo¹

• ¹Regina Elena National Cancer Institute, Hospital Physiotherapy Institutes (IRCCS), Rome, Italy
• ²Sapienza University of Rome, Rome, Lazio, Italy
• ³University of Perugia, Perugia, Umbria, Italy

A total of 60 patients were collected. The most frequent clinical stage was IIIa (38,3%). Platinum based chemotherapy was delivered in 56 patients; it was associated with immunotherapy in 28 cases and to radiotherapy in 14 cases. All the patients underwent lobectomy and systematic lymphadenectomy, 25 via robotic surgery. There was no significant demographic difference between the two cohorts except for preoperative radiotherapy; over one-third of patients in the open cohort received radiotherapy, while no patients in the robotic cohort did (p<0.001). The hospital stay was statistically significantly shorter in the robotic group (6 days (4-17) vs 8 (5 -29); p=0.02). Postoperative complication rates were lower (42,8% vs 20%, p=0.04) and the daily drainage output was significantly lower (p=0.0001). The NLR evaluated in V postoperative days was significantly lower in the robotic group (3.36±1.99 vs 7.27±2.59, p=0.0001).From the results obtained in this study, in patients with locally advanced resectable NSCLC, robotic surgery seems to be safe and feasible yielding a fewer complication rate, shorter hospital stay, less daily drainage volume and a lower NLR. Despite significant selection bias between cohorts, particularly regarding the use of preoperative radiotherapy which might have influenced the outcomes, robotic surgery appears feasible and yields comparable short-term outcomes for patients with locally advanced NSCLC following neoadjuvant therapy.