Objective To evaluate the outcomes of sleeve resection following neoadjuvant chemoimmunotherapy for lung cancer. Methods The clinical data of patients diagnosed with lung cancer and underwent sleeve lobectomy surgery at Tianjin Chest Hospital were retrospectively analyzed. Patients were divided into two groups: a neoadjuvant treatment group and a surgery alone group. The clinical data of two groups were compared. Results Finally 22 patients were collected, including 19 males and 3 females with a median age of 63 years. There were 7 patients in the neoadjuvant treatment group, and 15 patients in the surgery alone group. There was no statistical difference in surgical time, intraoperative bleeding, lymph node dissection, postoperative catheterization time, or postoperative drainage volume between the two groups (P>0.05). In the neoadjuvant treatment group, 1 patient had a second thoracotomy exploration for hemostasis due to bronchial artery bleeding, 2 patients had wound infection, 1 patient had immune-associated pneumonia before surgery, and 1 patient had immune-associated pneumonia before postoperative adjuvant therapy. Postoperative pathological results of patients in the neoadjuvant treatment group showed that 1 (1/7, 14.3%) patient had pathological complete response, and 3 (3/7, 42.9%) patients achieved major pathological response. Conclusion Neoadjuvant chemoimmunotherapy can lead to complications, including operation-related complications and immunotherapy-related complications. However, the degree of postoperative pathological remission is also significantly improved. Overall, sleeve resection following neoadjuvant chemoimmunotherapy can be considered as a treatment option for patients with lung cancer.
ObjectiveTo explore the predictive value of the pre-treatment systemic immune-inflammation index (SII) for major pathological response (MPR) after neoadjuvant immunochemotherapy (nICT) in esophageal cancer, and to construct a clinical prediction model combined with relevant clinical characteristics. Methods Retrospective collection of clinical data from patients with locally advanced esophageal cancer who received nICT followed by radical surgery at the First People's Hospital of Jining from January 2022 to June 2023. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of pre-treatment SII and neutrophil-lymphocyte ratio (NLR) for the efficacy of nICT in esophageal cancer. The optimal cut-off value was determined based on the maximum Youden index. Further, univariate and multivariate logistic regression analyses were employed to identify predictors for MPR after nICT in esophageal cancer and to construct a nomogram model. The model was evaluated using the area under the ROC curve (AUC), and internal validation was conducted using the Bootstrap method. ResultsA total of 63 patients were included, with 38 males and 25 females, and a median age of 67 (49-79) years. The ROC curve indicated that the optimal cut-off value for pre-treatment SII was 521.7, with an AUC of 0.701 [95%CI (0.564, 0.838)] for predicting MPR after nICT in esophageal cancer. The ROC curve showed that the optimal cut-off value for pre-treatment NLR was 2.32, with an AUC of 0.681 [95%CI (0.544, 0.818)]. Multivariate logistic regression analysis results revealed cT stage [OR=0.232, 95%CI (0.071, 0.759), P=0.016] and SII [OR=5.477, 95%CI (1.584, 18.939), P<0.001] as independent predictors for MPR after nICT in esophageal cancer. Based on the multivariate logistic regression results, a clinical prediction model was constructed, with an AUC of 0.789 on the ROC curve. The calibration plot showed a good agreement between the prediction curve and the ideal curve. ConclusionPre-treatment SII can serve as an independent predictive indicator for MPR in patients with esophageal cancer after nICT. The clinical model, established in combination with cT stage, can better predict the efficacy of nICT in esophageal cancer.