To evaluate the efficacy, surgical safety, and prognosis of induction immunochemotherapy followed by surgery for advanced nonsmall cell lung cancer (NSCLC). We retrospectively analyzed 143 patients with clinical stage IIB-IVA NSCLC who received induction immunochemotherapy using data from a prospectively maintained database. Survival outcomes were assessed using the Kaplan-Meier method and Cox proportional hazards models. The cohort (N = 143) was predominantly male (92.3%), with clinical stage III-IV (86.7%). Following induction immunochemotherapy, surgical resection was performed in 139 patients (97.2%), with an R0 resection rate of 99.3%. Pathological complete response (pCR) and major pathological response (MPR) rates were 38.8% and 62.6%, respectively, both significantly higher in squamous cell carcinoma (SCC) than in adenocarcinoma (ADC) (p = 0.006). Video-assisted thoracoscopic surgery (VATS) was performed in 87.1% of resections, with a 14.0% conversion rate. Postoperative complications occurred in 33.1% of patients, mostly Clavien-Dindo grade I-II, with no perioperative mortality. At a median follow-up of 23.0 months, the 2-year event-free survival (EFS) and overall survival (OS) rates were 80.1% and 91.8%, respectively. Achieving pCR or MPR and SCC histology were associated with significantly better EFS (p < 0.05). Adjuvant immunotherapy was administered to 59.7% of patients; however, it did not significantly improve survival, regardless of whether patients achieved pCR. Induction immunochemotherapy followed by surgery demonstrates highly effective for advanced NSCLC, achieving encouraging pathological response, favorable survival and a manageable safety profile, particularly in patients with SCC. These results provide a rationale for further prospective validation.
Mi et al. (Wed,) studied this question.
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