ArticleInterdisciplinary cardiovascular and thoracic surgery2026
Surgery After Induction Immuno-Chemotherapy in Stage III-N3 Non-Small Cell Lung Cancer: A Single-Centre Retrospective Cohort Study.
Article in Interdisciplinary cardiovascular and thoracic surgery, 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
objectivesThe goal of this study was to preliminarily evaluate the efficacy of a surgical procedure following induction immuno-chemotherapy and nodal downstaging in patients with stage III-N3 non-small cell lung cancer (NSCLC).
methodsA retrospective analysis was conducted on patients with stage III-N3 NSCLC who received induction immuno-chemotherapy at Shanghai Pulmonary Hospital from August 2019 to May 2023. Patients who achieved confirmed N3 lymph node downstaging, had resectable tumours, and maintained adequate performance status subsequently underwent a surgical procedure after induction therapy. In this post-induction comparative analysis, baseline characteristics and oncological outcomes were compared between patients who underwent surgical procedures and those who did not.
resultsAfter induction therapy, 28 (24.6%) patients underwent a surgical procedure, while 78 (73.6%) did not. The patients in the surgical group were younger (P = .012), had a higher body mass index (P = .032), and exhibited a higher proportion of contralateral mediastinal or hilar lymph node involvement (P = .024). Compared with those who did not undergo a surgical procedure, patients who did undergo a surgical procedure showed better progression-free survival (hazard ratio [HR] = 0.46, 95% CI, 0.23-0.92) and overall survival (HR = 0.31, 95% CI, 0.11-0.88). However, in the biopsy subgroup, patients who underwent a surgical procedure had better overall survival (HR = 0.64, 95% CI, 0.19-2.20) but similar progression-free survival (HR = 0.97, 95% CI, 0.42-2.23) compared with those who did not undergo a surgical procedure.
conclusionsThese real-world findings provide early positive signals that a surgical procedure after induction immuno-chemotherapy may be feasible in carefully selected patients with stage III-N3 NSCLC.
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