Neoadjuvant Chemoimmunotherapy in Non-small-cell Lung Cancer Patients: Effects on Pulmonary Function and Incidence of Postoperative Pulmonary Complications—A Multicentre Real-World Study

作者：Jian Zhang, Yi Feng, Shaohua Dai, Guoqiu Xu, Bo Cheng, Lei Jiang, Xue Li, Wenhua Liang, Jian Bing Tang · 发表于：European Journal of Cardio-Thoracic Surgery · 年份：2025 · DOI：10.1093/ejcts/ezaf351 · 被引用次数：3 · 研究领域：Lung Cancer Diagnosis and Treatment、Lung Cancer Research Studies、Cancer Immunotherapy and Biomarkers

OBJECTIVES: To evaluate the effects of neoadjuvant chemoimmunotherapy on pulmonary function and the incidence of postoperative pulmonary complications in real-world non-small-cell lung cancer patients. METHODS: A retrospective analysis of stage II-IIIB non-small-cell lung cancer patients who received neoadjuvant chemoimmunotherapy across 3 medical institutions was conducted. Clinical data and perioperative outcomes were evaluated. RESULTS: A total of 386 patients were screened and enrolled in the study cohort, and all patients underwent surgery after completing neoadjuvant chemoimmunotherapy. Postoperatively, 61 patients developed postoperative pulmonary complications, among whom 25 were diagnosed with checkpoint inhibitor-related pneumonia. The postoperative mortality rate was 2.8% (11/386), with all deaths attributed to severe postoperative checkpoint inhibitor-related pneumonia. The diffusing capacity of the lung for carbon monoxide tended to decrease after neoadjuvant chemoimmunotherapy, with 39% of patients developing impaired pulmonary function post-treatment. After controlling for confounding variables via propensity score matching analysis, impaired pulmonary function after treatment was associated with postoperative pulmonary complications. Multivariable logistic regression analysis revealed that prior lung disease (odds ratio, [OR]: 1.63; 95% CI, 1.02-3.31, P = .037), impaired pulmonary function after treatment (OR: 2.78; 95% CI, 1.38-5.24, P < .001), lymph node met...