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  11. Surgery Challenges And Postoperative Complications Of Lung Cancer After Neoadjuvant Immunotherapy

Surgery challenges and postoperative complications of lung cancer after neoadjuvant immunotherapy

Guangyu Bai1, Xiaowei Chen1, Yue Peng2

  • 1Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Thoracic Cancer
|April 4, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Neoadjuvant chemoimmunotherapy for lung cancer may increase surgical difficulty but keeps postoperative complications manageable. Strategies to reduce open surgery conversion and pneumonectomy are recommended for better patient outcomes.

Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Immunotherapy

Background:

  • Limited real-world data exists on surgical challenges and complications following neoadjuvant immunotherapy for lung cancer in China.
  • Neoadjuvant immunotherapy is increasingly used for lung cancer, necessitating an understanding of its surgical implications.

Purpose of the Study:

  • To analyze surgical difficulty and postoperative complications in lung cancer patients treated with neoadjuvant immunotherapy.
  • To identify risk factors associated with challenging surgeries and severe postoperative complications.

Main Methods:

  • Retrospective analysis of 261 lung cancer patients from January 2018 to January 2023.
  • Surgical difficulty classified by duration; complications graded by Clavien-Dindo system.
  • Logistic regression used to determine risk factors for surgical duration and complications.
Keywords:
immunotherapyneoadjuvantpostoperative complicationssurgical challenge

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Main Results:

  • 43.7% of surgeries were classified as challenging; overall postoperative complication rate was 22.2%.
  • Independent risk factors for challenging surgeries included smoking history, chemoimmunotherapy, and conversion to open surgery.
  • Pneumonectomy was a protective factor for challenging surgeries but a risk factor for complications; challenging surgeries also increased complication risk.

Conclusions:

  • Neoadjuvant chemoimmunotherapy can increase surgical difficulty, yet postoperative complications remain acceptable.
  • Minimizing conversion to open surgery and pneumonectomy is crucial after neoadjuvant immunotherapy for lung cancer.