Radical Minimally invasive surgery following immuno-chemotherapy in Initially-unresectable stage IIIB Non-small cell lung cancer
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Radical Minimally invasive surgery following immuno-chemotherapy in Initially-unresectable stage IIIB Non-small cell lung cancer. / Deng, Hongsheng; Liu, Jun; Cai, Xiuyu; Chen, Jiawei; Gaetano, Rocco; Petersen, René Horsleben; Brunelli, Alex; Ng, Calvin S. H.; D'Amico, Thomas A.; Liang, Wenhua; He, Jianxing.
In: Annals of Surgery, Vol. 275, No. 3, 2022, p. 600-602.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Radical Minimally invasive surgery following immuno-chemotherapy in Initially-unresectable stage IIIB Non-small cell lung cancer
AU - Deng, Hongsheng
AU - Liu, Jun
AU - Cai, Xiuyu
AU - Chen, Jiawei
AU - Gaetano, Rocco
AU - Petersen, René Horsleben
AU - Brunelli, Alex
AU - Ng, Calvin S. H.
AU - D'Amico, Thomas A.
AU - Liang, Wenhua
AU - He, Jianxing
N1 - Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022
Y1 - 2022
N2 - INTRODUCTION: Use of neoadjuvant immunotherapy agent in advanced stage NSCLC is controversial. Herein, we aim to report on a case series of successful conversion from initial unresectable stage cIIIB NSCLC to radical minimally invasive surgery through immunochemotherapy; with particular attention given to surgical outcomes and survival benefit of surgery.METHODS: Fifty-one patients with initial stage cIIIB NSCLC who received PD-1 agents plus platinum-based chemotherapy between May, 2018 to August, 2020 were retrospectively identified. Surgical and oncological outcomes of enrolled patients were collected.RESULTS: Of 31 patients who underwent subsequent resection, 23 (74.2%) patients underwent lobectomy, 1 (3.2%) underwent pneumonectomy, 5 (16.1%) underwent sleeve lobectomy, and 2 (6.5%) with bilobectomy. The median surgical time was 205 minutes (range, 100-520). The average blood loss was 185 (range: 10-1100) ml. Dense adhesions or fibrosis was noted in 15 cases. The median postoperative hospital stay was 6 (range: 3-13) days. No surgical-related mortality was recorded, only 5 patients (16.1%) experienced any postoperative morbidity (no grade 3 complications). Ten patients (32.3%) had major pathological response, with mediastinal down-staging been observed in 22/31 (71.0%) patients. With a median after up of 15.4 months, thirty-one patients that had surgery had relatively longer median DFS/PFS compared to that of either non-responders or responders that without surgery (27.5 vs. 4.7 vs. 16.7 months, respectively).CONCLUSIONS: Radical surgery after chemoimmunotherapy in initial unresectable stage IIIB NSCLC seems to be safe with low surgical-related mortality and morbidity, and was favorably associated with longer DFS/PFS compared to those without surgery.
AB - INTRODUCTION: Use of neoadjuvant immunotherapy agent in advanced stage NSCLC is controversial. Herein, we aim to report on a case series of successful conversion from initial unresectable stage cIIIB NSCLC to radical minimally invasive surgery through immunochemotherapy; with particular attention given to surgical outcomes and survival benefit of surgery.METHODS: Fifty-one patients with initial stage cIIIB NSCLC who received PD-1 agents plus platinum-based chemotherapy between May, 2018 to August, 2020 were retrospectively identified. Surgical and oncological outcomes of enrolled patients were collected.RESULTS: Of 31 patients who underwent subsequent resection, 23 (74.2%) patients underwent lobectomy, 1 (3.2%) underwent pneumonectomy, 5 (16.1%) underwent sleeve lobectomy, and 2 (6.5%) with bilobectomy. The median surgical time was 205 minutes (range, 100-520). The average blood loss was 185 (range: 10-1100) ml. Dense adhesions or fibrosis was noted in 15 cases. The median postoperative hospital stay was 6 (range: 3-13) days. No surgical-related mortality was recorded, only 5 patients (16.1%) experienced any postoperative morbidity (no grade 3 complications). Ten patients (32.3%) had major pathological response, with mediastinal down-staging been observed in 22/31 (71.0%) patients. With a median after up of 15.4 months, thirty-one patients that had surgery had relatively longer median DFS/PFS compared to that of either non-responders or responders that without surgery (27.5 vs. 4.7 vs. 16.7 months, respectively).CONCLUSIONS: Radical surgery after chemoimmunotherapy in initial unresectable stage IIIB NSCLC seems to be safe with low surgical-related mortality and morbidity, and was favorably associated with longer DFS/PFS compared to those without surgery.
U2 - 10.1097/SLA.0000000000005233
DO - 10.1097/SLA.0000000000005233
M3 - Journal article
C2 - 34596079
VL - 275
SP - 600
EP - 602
JO - Advances in Surgery
JF - Advances in Surgery
SN - 0003-4932
IS - 3
ER -
ID: 290532147