ArticleAnnals of surgical oncology2026
Efficacy of Adjuvant Chemoimmunotherapy versus Chemotherapy and the Impact of Lymph Node Dissection on Survival.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAdjuvant chemoimmunotherapy has recently become a standard treatment for pathological stage II-III non-small cell lung carcinoma (NSCLC). However, recent basic studies have suggested that lymph node (LN) dissection could attenuate the effect of adjuvant chemoimmunotherapy. We investigated the efficacy of adjuvant chemoimmunotherapy versus chemotherapy and the impact of lymph node dissection. PATIENTS AND
methodsUsing the National Cancer Database, patients diagnosed with pathological stage II-III NSCLC in 2021 who underwent adjuvant therapy were analyzed. The primary outcome was overall survival (OS) analyzed using the Kaplan-Meier method and multivariable Cox regression models. Propensity score matching (PSM) was performed to conduct a sensitivity analysis.
resultsWe identified 3229 and 926 patients who received adjuvant chemotherapy alone and adjuvant chemoimmunotherapy, respectively. Multivariable Cox regression analysis showed adjuvant chemoimmunotherapy significantly improved OS compared with adjuvant chemotherapy alone (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.59-0.88; p = 0.0010). After PSM, multivariable regression analyses indicated that adjuvant chemoimmunotherapy significantly improved OS in the high-LN dissection group (number of dissected LNs ≥ 20) (hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.37-0.99; p = 0.0450), although there were no significant differences in OS between the low-LN dissection (number of dissected LNs, 0-9) (HR, 0.74; 95% CI 0.48-1.14; p = 0.1701) and intermediate-LN dissection (number of dissected LNs, 10-19) (HR, 0.74; 95% CI 0.52-1.04; p = 0.0799) groups.
conclusionsOur results suggest that the efficacy of adjuvant chemoimmunotherapy for NSCLC is not attenuated by LN dissection.
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