ArticleFrontiers in surgery2026
Will neoadjuvant chemoimmunotherapy complicate subsequent surgery compared with adjuvant chemoimmunotherapy?
Article in Frontiers in 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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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.
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Abstract
Background: Neoadjuvant chemoimmunotherapy has significantly improved pathological response rates in resectable non-small cell lung cancer (NSCLC). However, whether it increases surgical complexity compared with upfront surgery followed by adjuvant therapy remains clinically debated. Methods: We retrospectively analyzed 121 NSCLC patients (81 neoadjuvant; 40 adjuvant) treated between 2021 and 2024. Inverse Probability of Treatment Weighting (IPTW) was applied to adjust for baseline imbalances. Surgical difficulty was quantified using a standardized 10-point scoring system. Multivariable logistic regression was then performed to identify independent risk factors for high-difficulty procedures (score >5). Results: IPTW successfully achieved balance across all baseline covariates. The neoadjuvant group exhibited significantly higher technical complexity than the adjuvant group (39.8% vs. 2.7% high difficulty; Conclusion: Neoadjuvant chemoimmunotherapy was associated with greater technical surgical difficulty and higher conversion rates compared with upfront surgery followed by adjuvant therapy. Despite these technical challenges, surgical resection remains safe and feasible, though it requires specialized thoracic expertise to manage complex anatomical alterations effectively.
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