ArticleFrontiers in medicine2026
Prognostic factors analysis of surgical resection after conversion therapy for isolated pleural metastatic lung cancer: a retrospective analysis.
Article in Frontiers in medicine, 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
Objective: To explore the efficacy and prognostic factors of surgical resection in patients with non-small cell lung cancer (NSCLC) and isolated pleural metastasis (M1a) after receiving individualized conversion therapy. Methods: This retrospective study included 167 patients with non-small cell lung carcinoma (NSCLC) and isolated pleural metastasis (M1a) admitted to Beijing Chest Hospital, Capital Medical University, from January 2019 to December 2023. Based on genotyping results, targeted therapy or chemo-immunotherapy regimens were administered. After conversion therapy, a multidisciplinary team (MDT) assessed surgical feasibility. The primary endpoint following comprehensive treatment was overall survival (OS) and progression-free survival (PFS), secondary endpoints included Objective response rate (ORR) and disease control rate (DCR); incidence of postoperative complications and Recurrence status. Survival probabilities were estimated using the Kaplan-Meier method, and independent prognostic factors were identified using the Cox proportional hazards regression model. Results: The median follow-up for all patients was 28.5 months. In total, 167 patients (82.26%) underwent curative or cytoreductive surgery. The median OS was 22.6 months (95%CI: 18.4-26.8), and the median PFS was 12.4 months (95% CI: 9.2-15.6). The 1-year and 2-year survival rates were 89.7 and 42.1%, respectively. Multivariate analysis revealed that squamous cell carcinoma (vs. adenocarcinoma, HR = 1.68, Conclusion: Surgical resection after effective conversion therapy significantly improves long-term survival in patients with isolated pleural metastatic lung cancer. Histological subtype, molecular characteristics, and completeness of resection are key prognostic indicators. Clinically, surgical intervention should prioritize patients who demonstrate a favorable response to conversion therapy, achieve R0 resection, and harbor driver gene mutations. Clinical trial registration: http://www.chictr.org.cn/, identifier ChiCTR2200056791.
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