ArticleWorld journal of surgical oncology2023
Prognostic factors affecting survival in patients with non-small cell lung cancer treated with salvage surgery after drug therapy: a multi-institutional retrospective study.
Article in World journal of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 8 citations in OpenAlex.
- Salvage surgery after epidermal growth factor receptor tyrosine kinase inhibitor therapy for non-small cell lung cancer: a focused narrative review.General thoracic and cardiovascular surgery · 2026Review
- International Consensus on Severe Lung Cancer-The Second Edition.Translational lung cancer research · 2026Review
- Comorbidities as predictors of postoperative pulmonary complications after lung cancer surgery.Journal of cardiothoracic surgery · 2026Article
- The Current Consensus on Salvage Surgery after Targeted Therapy for Advanced EGFR-Mutant Non-Small Cell Lung Cancer.Journal of chest surgery · 2026Review
- Salvage Surgery Following Systemic Therapy in Initially Unresectable Non-Small Cell Lung Cancer.Thoracic cancer · 2025Article
- Salvage Pulmonary Resection After Immune Checkpoint or Tyrosine Kinase Inhibitor Therapy for Initially Unresectable Non-Small-Cell Lung Cancer: A Systematic Review.Biomedicines · 2025Review
- Impacts of co-mutations in oligometastatic and oligoprogressive non-small cell lung cancer withTranslational lung cancer research · 2025Review
- Salvage surgery is safe and effective for clinical stage III non-small-cell lung cancer.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Spread through air spaces may predict early progression after salvage surgery for EGFR-mutant advanced lung adenocarcinoma treated with targeted therapy.World journal of surgical oncology · 2025Article
- PD-L1 expression from surgically resected lung tumors predictive of early progression in patients previously treated with targeted therapy for initially unresectable non-small cell lung cancer.Translational lung cancer research · 2024Article
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Authors and funding
15 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prevalence of salvage surgeries after drug therapy for non-small cell lung cancer (NSCLC) has risen, mainly due to recent progress in molecular-targeted drugs and immune checkpoint inhibitors for NSCLC. While the safety and effectiveness of salvage surgery after drug therapy for NSCLC have been studied, its indications remain unclear. We aimed to identify the prognostic factors affecting survival in patients with advanced-stage (stages III-IV) NSCLC treated with salvage surgery after drug therapy.
methodsA retrospective investigation was conducted on patients who received salvage surgery after drug therapy at four hospitals between 2007 and 2020. Salvage surgery was defined as surgery after drug therapy for local progression, tumor conversion to resectable status, and discontinuation of prior drug therapy owing to serious complications.
resultsThirty-two patients received cytotoxic agents alone (n = 12 [38%]), tyrosine kinase inhibitors (TKIs; n = 16 [50%]), or immune checkpoint inhibitors (n = 4 [13%]) as prior drug therapy. In 11 (34%) and 21 (66%) patients, the clinical stage before treatment was III or IV, respectively. The median initial and preoperative serum carcinoembryonic antigen (CEA) levels were 10.2 (range, 0.5-1024) ng/mL and 4.2 (range, 0.6-92.5) ng/mL, respectively. Among the patients, 28 (88%) underwent lobectomy, 2 (6%) underwent segmentectomy, and 2 (6%) underwent wedge resection. Complete resection of the primary lesion was accomplished in 28 (88%) patients. Postoperative complications were documented in six (19%) patients. Mortality rates were 0% at 30 days and 3% at 90 days post-operation. The 5-year overall survival rate stood at 66%, while the 5-year progression-free survival rate was 21%. Multivariate analyses showed that prior TKI therapy and preoperative serum CEA level < 5 ng/mL were prognostic factors influencing overall survival (hazard ratio [95% confidence interval]: 0.06 [0.006-0.68] and 0.03 [0.002-0.41], respectively). The 5-year overall survival in the 11 patients with both favorable prognosticators was 100%.
conclusionsIn this study, prior TKI therapy and preoperative serum CEA level < 5 ng/mL were favorable prognostic factors for overall survival in patients with NSCLC treated with salvage surgery. Patients with these prognostic factors are considered good candidates for salvage surgery after drug therapy.
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