Outcomes of surgical resection after neoadjuvant chemoimmunotherapy in locally advanced stage IIIA non-small-cell lung cancer.

Autor:	Romero Román A; Department of Thoracic Surgery, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain., Campo-Cañaveral de la Cruz JL; Department of Thoracic Surgery, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain., Macía I; Department of Thoracic Surgery, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain., Escobar Campuzano I; Department of Thoracic Surgery, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.; Department of Thoracic Surgery, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) and Unit of Human Anatomy and Embryology, Department of Pathology and Experimental Therapeutics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.; Department of Thoracic Surgery, Hospital Universitari de Bellvitge;, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) and Department of Clinical Sciences, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain., Figueroa Almánzar S; Department of Thoracic Surgery, Hospital Clinic Universitari de València, Valencia, Spain., Delgado Roel M; Department of Thoracic Surgery, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain., Gálvez Muñoz C; Department of Thoracic Surgery, Hospital General Universitario de Alicante, Alicante, Spain., García Fontán EM; Department of Thoracic Surgery, Complejo Universitario de Vigo, Vigo, Spain., Muguruza Trueba I; Department of Thoracic Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain., Romero Vielva L; Department of Thoracic Surgery, Hospital Vall d'Hebrón, Barcelona, Spain., Cano Garcia JR; Department of Thoracic Surgery, Complejo Hospitalario Universitario Insular de Gran Canaria, Las Palmas, Spain., Martínez Téllez E; Department of Thoracic Surgery, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain., Partida González C; Department of Thoracic Surgery, Hospital Universitario La Paz, Madrid, Spain., Jiménez López MF; Department of Thoracic Surgery, Hospital Universitario de Salamanca, Salamanca, Spain., Jiménez Maestre U; Department of Thoracic Surgery, Hospital Universitario de Cruces, Bizkaia, Spain., Mongil Poce R; Department of Thoracic Surgery, Hospital Regional Universitario de Málaga, Málaga, Spain., Sánchez Lorente D; Department of Thoracic Surgery, Hospital Clinic i Provincial de Barcelona, Barcelona, Spain., Álvarez Kindelán A; Department of Thoracic Surgery, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain., Provencio Pulla M; Department of Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2021 Jul 14; Vol. 60 (1), pp. 81-88.
DOI:	10.1093/ejcts/ezab007
Abstrakt:	Objectives: This analysis aimed to evaluate perioperative outcomes of surgical resection following neoadjuvant treatment with chemotherapy plus nivolumab in resectable stage IIIA non-small-cell lung cancer. Methods: Eligible patients received neoadjuvant chemotherapy (paclitaxel + carboplatin) plus nivolumab for 3 cycles. Reassessment of the tumour was carried out after treatment and patients with at least stable disease as best response underwent pulmonary resection. After surgery, patients received adjuvant treatment with nivolumab for 1 year. Surgical data were collected from the NADIM database and patient charts were reviewed for additional surgical details. Results: Among 46 patients who received neoadjuvant treatment, 41 (89.1%) underwent surgery. Two patients rejected surgery and 3 did not fulfil resectability criteria. There were 35 lobectomies (85.3%), 3 of which were sleeve lobectomies (9.4%), 3 bilobectomies (7.3%) and 3 pneumonectomies (7.3%). Video-assisted thoracoscopy was the initial approach in 51.2% of cases, with a conversion rate of 19% (n = 4). There was no operative mortality at either 30 or 90 days. The most common complications were prolonged air leak (n = 8), pneumonia (n = 5) and arrhythmia (n = 4). Complete resection (R0) was achieved in all patients who underwent surgery, downstaging was observed in 37 patients (90.2%) and major pathological response in 34 patients (82.9%). Conclusions: Surgical resection following induction therapy with chemotherapy plus nivolumab appears to be safe and offers appropriate oncological outcomes. Perioperative morbidity and mortality rates in our study were no higher than previously reported in this setting. A minimally invasive approach is, therefore, feasible. (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Databáze:	MEDLINE
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