Outcomes of surgical resection after neoadjuvant chemoimmunotherapy in locally advanced stage IIIA non-small-cell lung cancer
| Autor: | Alejandra Romero Román, Marcelo Lopez, Roberto Mongil Poce, Carlos Munoz, Jose Luis Campo-Cañaveral de la Cruz, Unai Jiménez Maestre, Ivan Macia, Elisabeth Martínez Téllez, David Lorente, Mariano Provencio Pulla, María Delgado Roel, José Ramón Cano Garcia, Ignacio Muguruza Trueba, Santiago Figueroa Almánzar, Laura Romero Vielva, Eva M García Fontán, Concepción Partida González, Antonio Álvarez Kindelán, Ignacio Escobar Campuzano |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Pneumonectomy Chemoimmunotherapy Carcinoma Non-Small-Cell Lung Antineoplastic Combined Chemotherapy Protocols medicine Thoracoscopy Humans Lung cancer Neoadjuvant therapy Neoplasm Staging medicine.diagnostic_test business.industry General Medicine Perioperative medicine.disease Chemotherapy regimen Neoadjuvant Therapy Surgery Treatment Outcome Nivolumab Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 60:81-88 |
| ISSN: | 1873-734X 1010-7940 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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