Effective induction immunotherapy minimizes surgical invasiveness for locally advanced lung cancer

Scientific paper - Original scientific paper

• Author: Feichao Bao
• Author: Jiaming Wang
• Author: Chen Shen
• Author: Fenghao Yu
• Author: Marko Jakopović
• Author: Xiuxiu Hao
• Author: Yang Chen
• Author: Yiyang Wang
• Author: Zhitao Gu
• Author: Wentao Fang
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (english)

Background: Immunotherapy has been recommended for neoadjuvant therapy in patients with locally advanced non-small cell lung cancer (NSCLC). However, its effect on surgical resection has not yet been examined. This study aimed to examine the effect of induction immunotherapy on surgical resection in terms of the surgical approach, resection extent, and perioperative recovery.

Methods: We performed a real-world study comprising consecutive patients with clinical stage IB-IIIB NSCLC who received surgical resection after induction immunotherapy from January 2019 to September 2021. The perioperative outcomes were compared in terms of the surgical approach and resection extent.

Results: Among 68 patients, 37 (54.4%) achieved a clinical objective response. Standard resection was performed in 37 patients (54.4%), while extended resection was necessary in the other 31 patients (45.6%). Minimally invasive surgery (MIS) was attempted in 37 cases (54.4%), with only 1 (2.7%) conversion. MIS was significantly more commonly accomplished in patients with a clinical objective response than those without (67.6% vs. 35.5%, P=0.008). Patients with a clinical objective response were more likely to have their tumors removed via MIS and/or standard resection (75.7% vs. 51.6%, P=0.04), while those without a clinical objective response more often required extended resection using an open approach. Patients receiving standard resection or MIS had significantly better perioperative outcomes than those who underwent extended resection or thoracotomy (all P<0.05).

Conclusions: The results of this large single-center retrospective cohort indicate that in terms of a better clinical response, effective induction immunotherapy could help reduce the resection extent and/or provide more opportunities to perform MIS, resulting in better recovery.

• Keywords (english): Immunotherapy; minimally invasive surgery (MIS); non-small cell lung cancer (NSCLC); resection extent
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Translational Lung Cancer Research
• Numbering: vol. 13, no. 8, pp. 1964-1974
• p-ISSN: 2218-6751
• e-ISSN: 2226-4477
• DOI: https://doi.org/10.21037/tlcr-24-470
• URN:NBN: urn:nbn:hr:105:861914
• Publication: 2024
• Document URL: https://tlcr.amegroups.com/article/view/88384/html
• Type of resource: Text
• Access conditions: Open access
• Created on: 2025-03-24 08:53:38