Vein-first vs. artery-first: “does the order of vessel ligation during pulmonary lobectomy for NSLC affect circulating tumor cells and patient survival?”

In the May 2019 issue of JAMA Surgery, Wei and colleagues report the results of a fascinating two part study: the first consists of a multicenter, randomized clinical trial evaluating whether ligating effluent veins first during thoracoscopic lobectomy can reduce the dissemination of tumor cells in patients with non-small cell lung cancer (clinical stage I–II) (1); the second comprises a propensity-matched retrospective analysis of overall survival (OS) and disease-free survival (DFS) in patients undergoing vein-first versus artery-first lobectomies.