ArticleAnnals of surgical oncology2026
A Novel Prognostic Stratification for Patients with Non-small Cell Lung Cancer Following Surgical Resection After Neoadjuvant Therapy: A Retrospective Cohort Study.
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
backgroundThe purpose of this study was to assess the combined prognostic value of residual viable tumor (RVT) percentage and post-neoadjuvant lymph node (ypN) status in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), and to develop a novel histology-based risk stratification model. PATIENTS AND
methodsWe analyzed a cohort of 352 patients with non-small cell lung cancer (NSCLC) who underwent neoadjuvant therapy followed by resection. Histology-specific RVT cutoffs were determined using maximally selected rank statistics and time-dependent receiver operating characteristic (ROC) analysis, with stability assessed via bootstrap resampling. A three-tier model integrating RVT and ypN was created: low risk (RVT
resultsThe cohort included 155 patients with LUAD and 197 with LUSC (mean age 61.6 years; median follow-up 41 months). Major pathological and pathological complete response rates were 20.6% in LUAD and 45.2% in LUSC, with a significantly higher median RVT percentage in LUAD than in LUSC (60% versus 30%, p < 0.0001). Optimized prognostic RVT cutoffs were established at 65% in LUAD and 25% in LUSC, strongly stratifying both OS and RFS (all p < 0.0001). The three-tier risk model significantly stratified RFS and OS in both LUAD and LUSC cohorts (overall p < 0.0001), with all intergroup comparisons remaining significant (all p < 0.05). On multivariable analysis, compared with the low-risk group, the intermediate- and high-risk groups were associated with significantly increased risks of death and recurrence in both LUAD and LUSC. Bootstrap validation demonstrated minimal overfitting (optimism 0.000-0.001) and maintained discriminative ability for both RFS (C-indices: LUAD 0.646, LUSC 0.713) and OS (C-indices: LUAD 0.642, LUSC 0.744).
conclusionsWe established a novel histology-specific risk model for resected NSCLC after neoadjuvant therapy. This practical tool may help discriminate prognosis and guide personalized postoperative management.
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