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Perioperative Outcomes and Survival After Preoperative Immunotherapy for Non-Small Cell Lung Cancer.

Publication ,  Journal Article
Mayne, NR; Potter, AL; Bharol, K; Darling, AJ; Raman, V; Cao, C; Li, X; D'Amico, TA; Jeffrey Yang, C-F
Published in: Ann Thorac Surg
June 2022

BACKGROUND: Although preoperative immunotherapy is increasingly utilized for non-small cell lung cancer, there remains a paucity of robust clinical data on its safety and long-term survival. Our objective was to evaluate the perioperative outcomes and survival associated with immunotherapy followed by surgery for patients with non-small cell lung cancer. METHODS: Outcomes of patients with non-small cell lung cancer who underwent lung resection after preoperative chemotherapy with or without radiation or immunotherapy (with or without chemotherapy or chemoradiation) in the National Cancer Database (2010 to 2017) were evaluated using Kaplan-Meier analysis, multivariable logistic regression, multivariable Cox proportional hazards analysis, and propensity score-matched analysis. RESULTS: From 2010 to 2017, 236 patients (2.2%) received immunotherapy and 10 715 patients received preoperative chemotherapy followed by surgery. There were no significant differences between the immunotherapy and preoperative chemotherapy groups with regard to margin positivity (8.5% [n = 20] vs 7.5% [n = 715], P = .98), 30-day readmission (4.2% [n = 10] vs 4.1% [n = 440], P = .87), and 30-day mortality (0.4% [n = 1] vs 2.4% [n = 253], P = .25). The immunotherapy and preoperative chemotherapy groups had similar overall survival (5-year survival 63% [95% confidence interval, 50% to 74%] vs 51% [95% confidence interval, 50% to 52%], log rank P = .06; multivariable adjusted hazard ratio 0.98; 95% confidence interval, 0.67 to 1.41; P = .90). A propensity score matched analysis of 344 patients, well matched by preoperative characteristics, showed no significant differences in short-term outcomes and overall survival (log rank P = 1.00) between the two groups. CONCLUSIONS: In this national analysis, preoperative immunotherapy followed by surgery for non-small cell lung cancer was found to be safe and feasible with similar short-term outcomes and overall survival when compared with preoperative chemotherapy followed by surgery.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

June 2022

Volume

113

Issue

6

Start / End Page

1811 / 1820

Location

Netherlands

Related Subject Headings

  • Retrospective Studies
  • Respiratory System
  • Propensity Score
  • Pneumonectomy
  • Neoplasm Staging
  • Lung Neoplasms
  • Immunotherapy
  • Humans
  • Chemoradiotherapy
  • Carcinoma, Non-Small-Cell Lung
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mayne, N. R., Potter, A. L., Bharol, K., Darling, A. J., Raman, V., Cao, C., … Jeffrey Yang, C.-F. (2022). Perioperative Outcomes and Survival After Preoperative Immunotherapy for Non-Small Cell Lung Cancer. Ann Thorac Surg, 113(6), 1811–1820. https://doi.org/10.1016/j.athoracsur.2021.06.058
Mayne, Nicholas R., Alexandra L. Potter, Kashika Bharol, Alice J. Darling, Vignesh Raman, Christopher Cao, Xiao Li, Thomas A. D’Amico, and Chi-Fu Jeffrey Yang. “Perioperative Outcomes and Survival After Preoperative Immunotherapy for Non-Small Cell Lung Cancer.Ann Thorac Surg 113, no. 6 (June 2022): 1811–20. https://doi.org/10.1016/j.athoracsur.2021.06.058.
Mayne NR, Potter AL, Bharol K, Darling AJ, Raman V, Cao C, et al. Perioperative Outcomes and Survival After Preoperative Immunotherapy for Non-Small Cell Lung Cancer. Ann Thorac Surg. 2022 Jun;113(6):1811–20.
Mayne, Nicholas R., et al. “Perioperative Outcomes and Survival After Preoperative Immunotherapy for Non-Small Cell Lung Cancer.Ann Thorac Surg, vol. 113, no. 6, June 2022, pp. 1811–20. Pubmed, doi:10.1016/j.athoracsur.2021.06.058.
Mayne NR, Potter AL, Bharol K, Darling AJ, Raman V, Cao C, Li X, D’Amico TA, Jeffrey Yang C-F. Perioperative Outcomes and Survival After Preoperative Immunotherapy for Non-Small Cell Lung Cancer. Ann Thorac Surg. 2022 Jun;113(6):1811–1820.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

June 2022

Volume

113

Issue

6

Start / End Page

1811 / 1820

Location

Netherlands

Related Subject Headings

  • Retrospective Studies
  • Respiratory System
  • Propensity Score
  • Pneumonectomy
  • Neoplasm Staging
  • Lung Neoplasms
  • Immunotherapy
  • Humans
  • Chemoradiotherapy
  • Carcinoma, Non-Small-Cell Lung