{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:29:45Z","timestamp":1790094585755,"version":"4.0.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies report a 20% conversion to open thoracotomy and 25% major morbidity rate for minimally invasive thoracic surgery following neoadjuvant chemotherapy or immunotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective review includes a consecutive (non-selected) series of patients from two surgeons who underwent robotic resection after neoadjuvant therapy for non-small cell lung cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From January 2018 to October 2024, 150 patients (51% male) underwent surgery following systemic therapy. The median age was 67 years. Preoperatively, 92% received chemotherapy, 65% immunotherapy, and 27% radiation. Median time from therapy to surgery was 6 weeks. The most common tumor type was stage IIIA adenocarcinoma (25%). Median operative time was 152\u2005min, and median blood loss was 20\u2005mL. There were no unplanned conversions to open thoracotomy or from lobectomy to pneumonectomy. Median length of stay was 1 day; 28% had chest tube removed on the day of surgery. Twenty-one patients experienced Clavien-Dindo grade III complications (primarily atrial fibrillation and effusion). There were no 30-day mortalities and two 90-day mortalities. Median follow-up was 19 months, with a median postoperative survival of 513 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Robotic lobectomy and pneumonectomy can be safely performed after neoadjuvant therapy, with conversion rates &amp;lt;1% and minimal 30- and 90-day mortality. Key technical factors include intra-pericardial control of the pulmonary artery, division of the lobar airway prior to pulmonary artery dissection, and performing surgery within 6 weeks of completing neoadjuvant therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1765234","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:03:26Z","timestamp":1779285806000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of robotic anatomic lung resection after neoadjuvant therapy for non-small cell lung cancer"],"prefix":"10.3389","volume":"13","author":[{"given":"Camille","family":"Yongue","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, NYU Langone Health","place":["New York City, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammar","family":"Asban","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, NYU Langone Health","place":["New York City, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"McCormack","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, RWJ Barnabas","place":["West Orange, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline A.","family":"Snyder","sequence":"additional","affiliation":[{"name":"NYU School of Medicine","place":["New York City, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, NYU Langone Health","place":["New York City, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Pachos","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, NYU Langone Health","place":["New York City, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Zervos","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, NYU Langone Health","place":["New York City, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Cerfolio","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, NYU Langone Health","place":["New York City, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"4033","DOI":"10.3390\/cancers13164033","article-title":"Lung cancer surgery after neoadjuvant immunotherapy","volume":"13","author":"Stefani","year":"2021","journal-title":"Cancers (Basel)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"314","DOI":"10.5306\/wjco.v13.i5.314","article-title":"Neoadjuvant treatment in non-small cell lung cancer: new perspectives with the incorporation of immunotherapy","volume":"13","author":"Aguado","year":"2022","journal-title":"World J Clin Oncol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2761","DOI":"10.21037\/tlcr-24-781","article-title":"The time-to-surgery interval and its effect on pathological response after neoadjuvant chemoimmunotherapy in non-small cell lung cancer: a retrospective cohort study","volume":"13","author":"Lin","year":"2024","journal-title":"Transl Lung Cancer Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1016\/j.jtcvs.2022.01.019","article-title":"Surgical outcomes after neoadjuvant nivolumab or nivolumab with ipilimumab in patients with non-small cell lung cancer","volume":"164","author":"Sepesi","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1093\/ejcts\/ezy166","article-title":"Robotic resection of stage III lung cancer: an international retrospective study","volume":"54","author":"Veronesi","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"The Clavien-Dindo classification of surgical complications","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.jtcvs.2018.11.124","article-title":"Initial results of pulmonary resection after neoadjuvant nivolumab in patients with resectable non-small cell lung cancer","volume":"158","author":"Bott","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1973","DOI":"10.1056\/NEJMoa2202170","article-title":"Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer","volume":"386","author":"Forde","year":"2022","journal-title":"N Engl J Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/j.atssr.2024.02.008","article-title":"Institutional experience with robotic lobectomy after neoadjuvant immunotherapy and chemotherapy","volume":"2","author":"Mack","year":"2024","journal-title":"Ann Thorac Surg Short Rep"},{"key":"B10","doi-asserted-by":"publisher","first-page":"969545","DOI":"10.3389\/fonc.2022.969545","article-title":"Robotic-assisted thoracic surgery following neoadjuvant chemoimmunotherapy in patients with stage III non-small cell lung cancer: a real-world prospective cohort study","volume":"12","author":"Gao","year":"2022","journal-title":"Front Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1134713","DOI":"10.3389\/fonc.2023.1134713","article-title":"Safety and feasibility of robotic-assisted thoracic surgery after neoadjuvant chemoimmunotherapy in non-small cell lung cancer","volume":"13","author":"Zeng","year":"2023","journal-title":"Front Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1016\/j.athoracsur.2024.05.004","article-title":"Discharging patients home with a chest tube and digital system after robotic lung resection","volume":"118","author":"Geraci","year":"2024","journal-title":"Ann Thorac Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.athoracsur.2021.06.088","article-title":"Discharging patients by postoperative day one after robotic anatomic pulmonary resection","volume":"114","author":"Geraci","year":"2022","journal-title":"Ann Thorac Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1589149","DOI":"10.3389\/fsurg.2025.1589149","article-title":"Improving quality outcomes via process improvements and innovation: the largest single-surgeon series of 1,701 consecutive robotic lobectomy and segmentectomy cases","volume":"12","author":"Cerfolio","year":"2025","journal-title":"Front Surg"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1765234\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:03:27Z","timestamp":1779285807000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1765234\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":14,"alternative-id":["10.3389\/fsurg.2026.1765234"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1765234","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"article-number":"1765234"}}