Video-Assisted Thoracoscopic Surgery Versus Thoracotomy Following Neoadjuvant Immunochemotherapy in Resectable Stage III Non-Small Cell Lung Cancer Among Chinese Populations: A Multi-Center Retrospective Cohort Study

作者：Hanbo Pan, Hang Chen, Weicheng Kong, Junwei Ning, Zhen Ge, Yu Tian, Ningyuan Zou, Hongda Zhu, Jiaqi Zhang, Yixing Tao, Zenan Gu, Min Zheng, Guomo Ruan, Long Jiang, Ziming Li, Jia Huang, Chengwei Zhou, Guodong Xu, Qingquan Luo · 发表于：Clinical Lung Cancer · 年份：2024 · DOI：10.1016/j.cllc.2024.03.008 · 被引用次数：16 · 研究领域：Lung Cancer Diagnosis and Treatment、Cancer Immunotherapy and Biomarkers、Pleural and Pulmonary Diseases

MicroAbstract This study spanned six Chinese medical centers and included 143 resectable stage III non-small cell lung cancer (NSCLC) patients with induction immunochemotherapy with a median follow-up of 29.5 months, demonstrating that video-assisted thoracoscopic surgery (VATS) led to decreased surgical-related pain, earlier chest tube removal, fewer postoperative complications, and comparable two-year survival outcomes to thoracotomy. Even when converted, VATS achieved perioperative outcomes equivalent to thoracotomy. Therefore, VATS could be considered feasible and oncologically effective for resectable stage III NSCLC after neoadjuvant immunochemotherapy. Background Immune checkpoint inhibitors have revolutionized non-small cell lung cancer (NSCLC) treatment but may pose greater technical challenges for surgery. This study aims to assess the feasibility and oncological effectiveness of video-assisted thoracoscopic surgery (VATS) for resectable stage III NSCLC after neoadjuvant immunochemotherapy. Methods Initial stage IIIA-IIIB NSCLC patients with neoadjuvant immunochemotherapy undergoing either VATS or open lobectomy at six medical centers during 2019-2023 were retrospectively identified. Perioperative outcomes and two-year survival were analyzed. Propensity-score matching (PSM) was employed to balance patient baseline characteristics. Results Among the total 143 patients, PSM yielded 62 cases each for VATS and OPEN groups. Induction-related adverse events were comparabl...