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Sleeve Lobectomy After Neoadjuvant Therapy for Non-Small Cell Lung Cancer: A Systematic Review and Meta-analysis
2026 · Hussein Mussa Muafa
Abstract Introduction: Sleeve lobectomy is a lung-sparing alternative to pneumonectomy for centrally located non-small cell lung cancer (NSCLC), but its safety after neoadjuvant therapy remains debated. Methods We performed a systematic review and meta-analysis of studies evaluating sleeve, bronchoplastic, bronchovascular, extended, or double sleeve resections after neoadjuvant therapy for NSCLC. Comparative outcomes were pooled using random-effects odds ratios (ORs). Primary outcomes were postoperative morbidity, airway/anastomotic complications, and short-term mortality. Results From 407 unique records, 29 primary studies were included qualitatively and 21 contributed to quantitative synthesis. Neoadjuvant therapy was not associated with significantly increased morbidity compared with upfront sleeve surgery (OR 1.20, 95% CI 0.88–1.63; I2 = 0%) or airway/anastomotic complications (OR 1.61, 95% CI 0.53–4.90). Compared with pneumonectomy after induction therapy, sleeve lobectomy showed lower morbidity (OR 0.53, 95% CI 0.29–0.97) and a lower but imprecise short-term mortality signal (OR 0.40, 95% CI 0.11–1.45). Chemoimmunotherapy did not increase postoperative complications versus chemotherapy alone (OR 0.65, 95% CI 0.31–1.33) and was associated with higher pathologic complete response (OR 5.42, 95% CI 1.94–15.14). Conclusion Sleeve lobectomy after neoadjuvant therapy appears feasible and generally safe in selected NSCLC patients treated in experienced centers. Sleeve resection should be favored over pneumonectomy when R0 resection is achievable, whereas chemoradiotherapy requires careful patient selection.
Contents
2027
Conclusion: Harnessing Your Superpowers
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Frontmatter
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chapter 4 The Veteran
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1 Childhood
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Index
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chapter 1 The Narrative Figure
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Index
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Frontmatter
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Epilogue
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4. Planning and Executing Mass Annihilation
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2. The Rakhine: Victim and Victimizer
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Contents
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4. Possible Livelihoods for an English Major
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Notes
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Glossary
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6 Polygamy
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7 Feminism
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6. Facilitating Genocide: The Special Case of the United Nations
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Frontmatter
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Acknowledgments
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8. Embedding Genocide
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1. An English Major’s Skill Set
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5 Activism
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5. Humanitarian Complicity in Genocide
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6. Networks and Mentors
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Bibliography
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9. Resisting the Naysayers
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chapter 2 The War Journalist
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3 Honor
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7. To Go or Not to Go to Graduate School? That’s Not the Question
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Introduction
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2 Dispossession
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Notes
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References
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7. The Struggle for Genocide Recognition
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Conclusion
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2. Storytelling
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3. Know Thyself as an English Major and Beyond
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Conclusion War Without End, Nation Divided
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Abbreviations
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chapter 5 The Military Family
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Introduction: Empowering English Majors
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1. Dehumanization and the Legalization of Discrimination
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Contents
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5. Internships and Beyond
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Acknowledgments
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8. Critical Thinking About Passion
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Index
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10. Life Pathways
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Epilogue
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References
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Preface
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chapter 3 The Active- Duty Service Member
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Chronology
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3. The Escalation of Genocide, 2012–2015
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About the Authors
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Frontmatter
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Acknowledgments
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