Department of Thoracic Surgery, Agaplesion Markus Krankenhaus Frankfurt, Frankfurt, Germany.
Department of Oncology, Agaplesion Markus Krankenhaus Frankfurt, Frankfurt, Germany.
Thorac Cardiovasc Surg. 2023 Dec;71(8):656-663. doi: 10.1055/a-2028-7955. Epub 2023 Feb 6.
Neoadjuvant immunochemotherapy is currently being tested in pivotal trials for stage I to III nonsmall cell lung cancer (NSCLC). The impact of immunochemotherapy in patients with oligometastatic disease (OMD) remains undefined. This study aimed to compare the outcomes of radical treatment after the neoadjuvant course of immunochemotherapy versus chemotherapy.
We retrospectively analyzed patients with OMD who were treated with immunochemotherapy or chemotherapy combined with local ablation of metastases and radical primary tumor resection between 2017 and 2021. Group A included eight patients with immunochemotherapy; Group B included seven patients with chemotherapy. Descriptive statistical analysis included the characteristics of the patients, tumors, and outcomes.
There was no difference in postoperative morbidity rates between the groups ( = 0.626). The 30-day mortality in both groups was 0%. The median overall survival for Group A was not reached, with a median follow-up time of 25 (range: 13-35) months; the median overall survival for Group B was 26 (range: 5-53) months. In Group A, all patients remained alive; in contrast, in Group B, four patients died ( = 0.026). There was no local thoracic recurrence in either group. In Group B, the recurrent disease was identified significantly more often (12.5 vs. 85.75%; = 0.009). The rates of complete and major pathologic response were 37.5 and 0% in Group A and 42.85 and 14.25% in Group B, respectively.
Despite the small patient number and short-term results, the progression-free and overall survival in patients with OMD after local therapy for metastases and primary tumor resection following a neoadjuvant course of immunochemotherapy might be promising compared with chemotherapy.
新辅助免疫化疗目前正在 I 期至 III 期非小细胞肺癌（NSCLC）的关键试验中进行测试。免疫化疗在寡转移疾病（OMD）患者中的影响仍未确定。本研究旨在比较新辅助免疫化疗与化疗后根治性治疗的结果。
我们回顾性分析了 2017 年至 2021 年间接受免疫化疗或化疗联合局部转移消融和根治性原发肿瘤切除术治疗的 OMD 患者。A 组包括 8 例接受免疫化疗的患者；B 组包括 7 例接受化疗的患者。描述性统计分析包括患者、肿瘤和结果的特征。
两组术后发病率无差异（=0.626）。两组 30 天死亡率均为 0%。A 组的中位总生存期未达到，中位随访时间为 25 个月（范围：13-35 个月）；B 组的中位总生存期为 26 个月（范围：5-53 个月）。A 组所有患者均存活；相比之下，B 组有 4 例患者死亡（=0.026）。两组均无局部胸内复发。B 组复发疾病的检出率明显更高（12.5%比 85.75%；=0.009）。A 组完全和主要病理缓解率分别为 37.5%和 0%，B 组分别为 42.85%和 14.25%。
尽管患者数量较少且结果为短期，但与化疗相比，OMD 患者在接受局部转移治疗和新辅助免疫化疗后行原发肿瘤切除术的无进展生存期和总生存期可能更有前景。
