Table 2. Oncological and surgical outcomes of neoadjuvant immunochemotherapy.
| Outcomes | n (%) | P value* | ||
|---|---|---|---|---|
| Total (n=115) | Stage IIIA (n=61) | Stage IIIB-C (n=54) | ||
| Clinical response | ||||
| CR | 1 (0.87) | 0 (0.00) | 1 (1.85) | 0.274 |
| PR | 69 (60.00) | 33 (54.10) | 36 (66.67) | |
| SD | 37 (32.17) | 24 (39.34) | 13 (24.07) | |
| PD | 1 (0.87) | 1 (1.64) | 0 (0.00) | |
| NA | 7 (6.09) | 3 (4.92) | 4 (7.41) | |
| Approach | ||||
| Thoracotomy | 12 (10.43) | 6 (9.84) | 6 (11.11) | 0.875 |
| VATS | 100 (86.96) | 53 (86.89) | 47 (87.04) | |
| VATS convert to thoracotomy | 3 (2.61) | 2 (3.28) | 1 (1.85) | |
| Type of resection | ||||
| Lobectomy# | 99 (86.09) | 50 (81.97) | 49 (90.74) | 0.262 |
| Pneumonectomy | 1 (0.87) | 0 (0.00) | 1 (1.85) | |
| Sleeve resection | 10 (8.70) | 7 (11.48) | 3 (5.56) | |
| Wedge resection | 5 (4.35) | 4 (6.56) | 1 (1.85) | |
| Pathological outcomes | ||||
| MPR | 20 (17.39) | 9 (14.75) | 11 (20.37) | 0.661 |
| pCR | 44 (38.26) | 23 (37.70) | 21 (38.89) | |
| <90% | 51 (44.35) | 29 (47.54) | 22 (40.74) | |
| Pathological nodal status | ||||
| N2 | 24 (20.87) | 8 (13.11) | 16 (29.63) | 0.093 |
| Single station | 11 (9.57) | 3 (4.92) | 8 (14.81) | |
| Multiple station | 13 (11.30) | 5 (8.20) | 8 (14.81) | |
| N1 | 15 (13.04) | 6 (9.84) | 9 (16.67) | |
| N0 | 76 (66.09) | 45 (73.77) | 31 (57.41) | |
| Overall nodal downstaging | 80 (69.57) | 42 (68.85) | 38 (70.37) | 0.646 |
| Downstaging of N2 nodal status | ||||
| N2 to N2 | 21 (25.93) | 8 (13.11) | 13 (24.07) | 0.704 |
| N2 to N1 | 11 (13.58) | 5 (8.20) | 6 (11.11) | |
| N2 to N0 | 49 (60.49) | 24 (39.34) | 25 (46.30) | |
| Recurrent rate | 28 (24.35) | 14 (22.95) | 14 (25.93) | – |
| Recurrent site | ||||
| Residual lung | 11 (9.57) | 4 (6.56) | 7 (12.96) | 0.677 |
| Lymph node | 6 (5.22) | 3 (4.92) | 3 (5.56) | |
| Bone metastasis | 6 (5.22) | 3 (4.92) | 3 (5.56) | |
| Brain metastasis | 3 (2.61) | 2 (3.28) | 1 (1.85) | |
| Spleen metastasis | 1 (0.87) | 1 (1.64) | 0 | |
| Systemic metastasis | 1 (0.87) | 1 (1.64) | 0 | |
*, P value refers to the chi-square test P value; #, included bilobectomy. CR, complete response; PR, partial response; SD, stable disease; PD, progression disease; NA, not available; VATS, video-assisted thoracoscopic surgery; MPR, major pathologic response; pCR, pathologic complete response; <90%, pathologic regression <90%.