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Impact of the interval between neoadjuvant immunochemotherapy and surgery on surgical–pathological outcomes in non-small cell lung cancer

INTRODUCTION: The interval between neoadjuvant immunochemotherapy and surgery in patients with non-small cell lung cancer (NSCLC) has not been well characterized. This study investigated the association between the time-to-surgery (TTS) interval and surgical–pathological outcomes. METHOD: Clinical d...

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Autores principales: Chen, Jiawei, Deng, Hongsheng, He, Jiaxi, Wang, Zhufeng, Li, Shuben
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9491272/
https://www.ncbi.nlm.nih.gov/pubmed/36158657
http://dx.doi.org/10.3389/fonc.2022.909726
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author Chen, Jiawei
Deng, Hongsheng
He, Jiaxi
Wang, Zhufeng
Li, Shuben
author_facet Chen, Jiawei
Deng, Hongsheng
He, Jiaxi
Wang, Zhufeng
Li, Shuben
author_sort Chen, Jiawei
collection PubMed
description INTRODUCTION: The interval between neoadjuvant immunochemotherapy and surgery in patients with non-small cell lung cancer (NSCLC) has not been well characterized. This study investigated the association between the time-to-surgery (TTS) interval and surgical–pathological outcomes. METHOD: Clinical data of patients who received neoadjuvant immun-ochemotherapy followed by surgery for NSCLC between January 2019 and September 2021 were collected. The patients were divided into three groups based on TTS interval: the early-surgery group (ESG), the standard-surgery group (SSG), and the delayed-surgery group (DSG). The primary outcomes were objective response rate (ORR), major pathological response (MPR), and pathological complete response (pCR). The secondary endpoint was surgical outcome. RESULTS: Of the 171 patients, 16 (9.4%) received surgery in ≤28 days, 49 (28.7%) received surgery within 29–42 days, and 106 (61.9%) received surgery in ≥43 days after neoadjuvant immunochemotherapy, with a median TTS of 46 days. The postoperative drainage of the ESG group (455.1 ml) was significantly less than that of the SSG group (680.7 ml) and the DSG group (846.5 ml; p = 0.037). However, the TTS interval did not influence the duration of the operation (P = 0.54), the extent of intraoperative bleeding (P = 0.60), or the length of postoperative hospital stay (P = 0.17). The ORR was observed in 69%, 51%, and 56% of patients in the ESG, the SSG, and the DSG, respectively (P = 0.46), and MPR occurred in 50%, 47%, and 58% (P = 0.38) of patients in the ESG, the SSG, and the DSG, respectively. Similarly, no statistically significant difference was found for pCR (ESG: 31%; SSG: 27%; DSG: 42%; P = 0.14). CONCLUSION: This retrospective study indicated that TTS exerts no significant effect on the feasibility and safety of surgery in the neoadjuvant immunochemotherapy setting of NSCLC. Analysis of the TTS interval revealed a tendency for delayed surgery to be associated with a pathological response in NSCLC, although this association was not statistically significant.
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spelling pubmed-94912722022-09-22 Impact of the interval between neoadjuvant immunochemotherapy and surgery on surgical–pathological outcomes in non-small cell lung cancer Chen, Jiawei Deng, Hongsheng He, Jiaxi Wang, Zhufeng Li, Shuben Front Oncol Oncology INTRODUCTION: The interval between neoadjuvant immunochemotherapy and surgery in patients with non-small cell lung cancer (NSCLC) has not been well characterized. This study investigated the association between the time-to-surgery (TTS) interval and surgical–pathological outcomes. METHOD: Clinical data of patients who received neoadjuvant immun-ochemotherapy followed by surgery for NSCLC between January 2019 and September 2021 were collected. The patients were divided into three groups based on TTS interval: the early-surgery group (ESG), the standard-surgery group (SSG), and the delayed-surgery group (DSG). The primary outcomes were objective response rate (ORR), major pathological response (MPR), and pathological complete response (pCR). The secondary endpoint was surgical outcome. RESULTS: Of the 171 patients, 16 (9.4%) received surgery in ≤28 days, 49 (28.7%) received surgery within 29–42 days, and 106 (61.9%) received surgery in ≥43 days after neoadjuvant immunochemotherapy, with a median TTS of 46 days. The postoperative drainage of the ESG group (455.1 ml) was significantly less than that of the SSG group (680.7 ml) and the DSG group (846.5 ml; p = 0.037). However, the TTS interval did not influence the duration of the operation (P = 0.54), the extent of intraoperative bleeding (P = 0.60), or the length of postoperative hospital stay (P = 0.17). The ORR was observed in 69%, 51%, and 56% of patients in the ESG, the SSG, and the DSG, respectively (P = 0.46), and MPR occurred in 50%, 47%, and 58% (P = 0.38) of patients in the ESG, the SSG, and the DSG, respectively. Similarly, no statistically significant difference was found for pCR (ESG: 31%; SSG: 27%; DSG: 42%; P = 0.14). CONCLUSION: This retrospective study indicated that TTS exerts no significant effect on the feasibility and safety of surgery in the neoadjuvant immunochemotherapy setting of NSCLC. Analysis of the TTS interval revealed a tendency for delayed surgery to be associated with a pathological response in NSCLC, although this association was not statistically significant. Frontiers Media S.A. 2022-09-07 /pmc/articles/PMC9491272/ /pubmed/36158657 http://dx.doi.org/10.3389/fonc.2022.909726 Text en Copyright © 2022 Chen, Deng, He, Wang and Li https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Chen, Jiawei
Deng, Hongsheng
He, Jiaxi
Wang, Zhufeng
Li, Shuben
Impact of the interval between neoadjuvant immunochemotherapy and surgery on surgical–pathological outcomes in non-small cell lung cancer
title Impact of the interval between neoadjuvant immunochemotherapy and surgery on surgical–pathological outcomes in non-small cell lung cancer
title_full Impact of the interval between neoadjuvant immunochemotherapy and surgery on surgical–pathological outcomes in non-small cell lung cancer
title_fullStr Impact of the interval between neoadjuvant immunochemotherapy and surgery on surgical–pathological outcomes in non-small cell lung cancer
title_full_unstemmed Impact of the interval between neoadjuvant immunochemotherapy and surgery on surgical–pathological outcomes in non-small cell lung cancer
title_short Impact of the interval between neoadjuvant immunochemotherapy and surgery on surgical–pathological outcomes in non-small cell lung cancer
title_sort impact of the interval between neoadjuvant immunochemotherapy and surgery on surgical–pathological outcomes in non-small cell lung cancer
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9491272/
https://www.ncbi.nlm.nih.gov/pubmed/36158657
http://dx.doi.org/10.3389/fonc.2022.909726
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