Observational studyAnnals of surgical oncology2026
Preoperative Predictors of Surgical Complexity After Neoadjuvant Immunochemotherapy in Non-small-cell Lung Cancer.
Observational study in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile neoadjuvant immunochemotherapy has improved outcomes of resectable nonsmall cell lung cancer (NSCLC), treatment-induced tissue changes can increase surgical complexity. This study aimed to identify preoperative predictors of technically challenging surgery following neoadjuvant immunochemotherapy. PATIENTS AND
methodsThis multicenter retrospective analysis included 114 patients who underwent surgery after neoadjuvant nivolumab plus platinum-based chemotherapy at 29 institutions between March 2023 and July 2024. Challenging surgery was defined as one requiring bronchoplasty, pulmonary artery angioplasty, or pneumonectomy. Logistic regression was used to identify preoperative predictors for surgical complexity.
resultsTwenty-one patients (18.4%) required challenging surgeries, including bronchoplasty (n = 13), pulmonary artery angioplasty (n = 1), double-sleeve resection (n = 4), and pneumonectomy (n = 3). These cases had longer operative times (340 ± 118 vs. 267 ± 98 min, p < 0.001) and more frequently required open thoracotomy (90.5% vs. 44.1%, p < 0.001). Conventional predictive factors (T/N status, programmed cell death ligand expression, radiological response, and treatment-to-surgery interval) showed no association with surgical complexity. Post-treatment extranodal extension (ENE) after neoadjuvant therapy and before surgery was the strongest predictor of challenging surgery (univariable odds ratio [OR] 7.06, 95% confidence interval [CI]: 1.45-34.41, p = 0.009). Post-treatment ENE demonstrated a higher predictive accuracy for challenging surgery (positive predictive value [PPV] 50.0%) than that of pathological ENE metastasis (PPV 14.3%); thus, positivity reflects treatment-induced anatomical changes rather than residual tumor invasion.
conclusionsUnlike conventional predictors, post-treatment ENE may predict surgical complexity after neoadjuvant immunochemotherapy. ENE may be a potential marker of treatment-induced anatomical complexity rather than residual tumor burden, enabling evidence-based surgical planning in the immunotherapy era.
Indexed as
Identifiers
42310265What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.