Lung Cancer Surgery Post Chemo/IO

Authored by Andrea Billè, published on 2026-09-04 20:50:22.0

Surgical decision making following chemoimmunotherapy for lung cancer, stratifying patients by tumor size, nodal status (N1 vs N2), and extent of invasion (e.g., T4). From minimally invasive lobectomy (VATS/RATS) to complex resections with vascular or chest wall involvement while emphasizing anatomical resection with appropriate lymph node dissection.

  1. SURGERY POST CHEMO/IO
    • Tumour bigger than 4 cm
      • VATS/RATS anatomical lung resection
        • Lobectomy
    • N1 disease
      • VATS/RATS*
        *High risk of conversion.
        • Lobectomy +/- bronchial or arterial sleeve
          * High risk of conversion
        • Pneumonectomy (central hilar LN)
    • N2 disease
      • VATS/RATS
        • Anatomical lung resection + mediastinal LN dissection
    • T4 invasion
      • VATS/RATS/open
        • Anatomical lung resection + RVS
          • Laminectomy
          • Subclavian vessels resection
          • SVC resection
          • Chest wall resection + reconstruction
            • Mediastinal fat tissue resection
tosprivacyNeoadjuvant nivolumab plus ipilimumab in resectable non-small cell lung cancerNCCN Guidelines Non-Small Cell Lung Cancer