Prognostic factors in neoadjuvant immunotherapy for non-small cell lung cancer：pathologic lymph node metastasis and primary tumor response

doi:10.3969/j.issn.1006-7795.2024.04.014

Abstract

Abstract: Objective To investigate the prognostic impact of pathologic lymph node metastasis and primary tumor response after neoadjuvant immunotherapy in patients with non-small cell lung cancer (NSCLC). Methods Clinicopathological data of 40 NSCLC patients who underwent surgical resection after neoadjuvant immunotherapy were retrospectively analyzed. The relationships of pathologic nodal stage (N1/N2) and primary tumor response ［pathological complete response (pCR)/major pathological response (MPR)/non-objective response (non-OR)］with progression-free survival (PFS) were evaluated, and a prognostic risk stratification model was established. Results Pathologic nodal stage and primary tumor response were not significantly associated with PFS when considered separately. However, their interaction had a significant impact on prognosis： for N1 patients, the ones with pCR/MPR had better PFS than those with non-OR (P =0.038); for N2 patients, primary tumor response was not significantly associated with PFS. Based on the interaction, patients were stratified into low-risk (N1+pCR/MPR) and high-risk (N1+non-OR/N2) groups, with significant differences in PFS (P =0.003). Conclusions The interaction between pathologic lymph node metastasis and primary tumor response is a key prognostic factor in NSCLC after neoadjuvant immunotherapy. The prognostic risk stratification model based on their interaction may help guide individualized treatment decisions, but prospective validation is needed.

Key words: non-small cell lung cancer, neoadjuvant immunotherapy, pathologic lymph node metastasis, primary tumor response, prognosis

CLC Number:

R734.2

Xu Yuan, Liang Naixin, Liu Hongsheng. Prognostic factors in neoadjuvant immunotherapy for non-small cell lung cancer：pathologic lymph node metastasis and primary tumor response[J]. Journal of Capital Medical University, 2024, 45(4): 649-653.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2024.04.014

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2024/V45/I4/649

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