ArticleJournal of cardiothoracic surgery2023
Salvage surgery for advanced non-small cell lung cancer following previous immunotherapy: a retrospective study.
Article in Journal of cardiothoracic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 8 citations in OpenAlex.
- Salvage Surgery: A Concrete Opportunity in Unresectable Non-Small Cell Lung Cancer Following Definitive Chemo-Immunotherapy.Cancers · 2025Article
- Short-term results of salvage surgery after immune and target therapies in non-small cell lung cancer.Journal of thoracic disease · 2025Article
- Delayed Bronchopleural Fistula Formation Following Salvage Surgery of Stage IV Anaplastic Lymphoma Kinase-Positive Non-Small-Cell Lung Cancer.Current oncology (Toronto, Ont.) · 2025Article
- Salvage surgery is safe and effective for clinical stage III non-small-cell lung cancer.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Salvage Lung Resection of Aspergilloma Mimicking Tumor Regrowth after Immune Checkpoint Inhibitor Therapy for Stage IV Squamous Cell Lung Cancer: A Case Report.Surgical case reports · 2025Article
- Clinical Outcomes and Histologic Findings of Patients With Hepatocellular Carcinoma With Durable Partial Response or Durable Stable Disease After Receiving Atezolizumab Plus Bevacizumab.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Article
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Authors and funding
5 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe development of systemic chemotherapy including immune checkpoint inhibitors (ICIs) has provided patients with unresectable advanced non-small cell lung cancer (NSCLC) an opportunity to undergo surgical intervention after initial treatment. However, no consensus regarding the indication for salvage surgery in these patients has been reached.
methodsWe conducted a retrospective study of patients who underwent salvage surgery for advanced NSCLC (cStage IIIA-IVB) after treatment with ICIs from January 2018 to December 2022 at Aizu Medical Center and Fukushima Medical University Hospital. We evaluated the patients' clinical data, calculated disease-free survival (DFS) and overall survival (OS), and assessed the survival benefit using the Kaplan-Meier method.
resultsThirteen patients underwent salvage surgery after immunotherapy. All patients achieved downstaging after initial chemotherapy. Eleven patients underwent lobectomy, and one patient underwent extirpation of intra-abdominal lymph nodes. The mean surgery time and intraoperative blood loss were 242.2 min and 415.1 g, respectively. The mean drainage period was 4.2 days (range, 2-9 days). Grade ≥ 3 postoperative complications were confirmed in three patients. The 2-year DFS rate was 71.2%, and the 2-year OS rate was 76.2%. A pathological complete response compatible with ypStage 0 was achieved in four (30.8%) patients. Patients with ypStage 0 and I achieved significantly better OS than those with ypStage ≥ II (p = 0.044), and patients without severe complications achieved significantly better DFS and OS than those with severe complications (p = 0.001 and p < 0.001, respectively).
conclusionsSalvage surgery after chemotherapy including ICIs is a feasible and effective treatment option for patients with advanced NSCLC, especially those who acquire downstaging to pathological stage 0 or I. However, severe perioperative complications might affect patient survival. A prospective study is urgently needed to evaluate the efficacy of salvage surgery.
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