Sleeve Lobectomy After Neoadjuvant Chemoimmunotherapy Versus Chemotherapy for Squamous Cell Lung Cancer: A Multicenter, Retrospective Study

Tianxiang Chen, MD, PhD; Junwei Ning, MD; Jianfei Shen, MD, PhD; Hui Pan, MD; Linhai Fu, MD; Enwu Xu, MD, PhD; Han Wu, MD; Jia Huang, MD, PhD; Yunhai Yang, MD, PhD; Ziming Li, MD, PhD; Qingquan Luo, MD, PhD

JTO Clinical and Research Reports (Apr 2023)

Sleeve Lobectomy After Neoadjuvant Chemoimmunotherapy Versus Chemotherapy for Squamous Cell Lung Cancer: A Multicenter, Retrospective Study

Tianxiang Chen, MD, PhD,
Junwei Ning, MD,
Jianfei Shen, MD, PhD,
Hui Pan, MD,
Linhai Fu, MD,
Enwu Xu, MD, PhD,
Han Wu, MD,
Jia Huang, MD, PhD,
Yunhai Yang, MD, PhD,
Ziming Li, MD, PhD,
Qingquan Luo, MD, PhD

Affiliations

Tianxiang Chen, MD, PhD: Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
Junwei Ning, MD: Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; Department of Thoracic Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
Jianfei Shen, MD, PhD: Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province, Whenzhou Medical University, Linhai, People’s Republic of China
Hui Pan, MD: Department of Thoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
Linhai Fu, MD: Department of Thoracic Surgery, Shaoxing People's Hospital, Shaoxing, People’s Republic of China
Enwu Xu, MD, PhD: Department of Thoracic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, People’s Republic of China
Han Wu, MD: Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
Jia Huang, MD, PhD: Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
Yunhai Yang, MD, PhD: Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
Ziming Li, MD, PhD: Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
Qingquan Luo, MD, PhD: Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; Corresponding author. Address for correspondence: Qingquan Luo, MD, PhD, Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, People’s Republic of China.

Journal volume & issue: Vol. 4, no. 4
p. 100472

Abstract

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Introduction: To analyze the feasibility and efficacy of sleeve lobectomy after neoadjuvant immunotherapy in multicenter patients with squamous cell lung cancer. Methods: We retrospectively identified patients who received neoadjuvant immunotherapy (n = 14) or chemotherapy alone (n = 33) at five thoracic surgery centers between 2018 and 2020. The primary end point was 30-day major complications. The secondary end point was major pathologic response. Multivariate analysis was performed with a log-binomial regression model adjusting potential risk factors. Results: All patients received induction therapy and underwent sleeve lobectomy without 90-day postoperative deaths. The distribution of age, sex, nutrition status, pulmonary and cardiac function, tumor stage, surgical approach, and location of the pulmonary lobe was well balanced between the two cohorts. In the immunotherapy cohort, two patients (14.3%) experienced a pulmonary major complication, whereas nine pulmonary major complications and one cardiac major complication (30.3%) occurred in the chemotherapy cohort (p = 0.302). Conclusions: Neoadjuvant immunotherapy in addition to chemotherapy did not increase 30-day risk of postoperative complications, and immunotherapy is a favorable factor affecting pathologic downstage and response. Therefore, sleeve lobectomy after induction chemoimmunotherapy appears safe and feasible.

Published in JTO Clinical and Research Reports

ISSN: 2666-3643 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/jto-clinical-and-research-reports/

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