Research Article|Articles in Press, 100472

Sleeve lobectomy after neoadjuvant chemoimmunotherapy versus chemotherapy for squamous cell lung cancer: a multicenter, retrospective study

Open AccessPublished:February 01, 2023DOI:
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      To analyze the feasibility and efficacy of sleeve lobectomy after neoadjuvant immunotherapy in multicenter patients with squamous cell lung cancer.


      We retrospectively identified patients who received neoadjuvant immunotherapy (n = 14) or chemotherapy alone (n = 33) at 5 thoracic-surgery centers between 2018 and 2020. The primary endpoint was 30-day major complications. The secondary endpoint was major pathological response. Multivariate analysis was performed with a log-binomial regression model adjusting potential risk factors.


      All patients received induction therapy and underwent sleeve lobectomy without 90-day postoperative deaths. The distribution of age, sex, nutrition status, pulmonary and cardiac function, tumor stage, surgical approach, and location of pulmonary lobe were well balanced between two cohorts. In immunotherapy cohort, 2 patients (14.3%) experienced a pulmonary major complication, whereas 9 pulmonary major complications and 1 cardiac major complication (30.3%) occurred in chemotherapy cohort patients (p = .302).


      Neoadjuvant immunotherapy in addition to chemotherapy did not increase 30-day risk of postoperative complications, and immunotherapy is a favorable factor affecting pathological downstage and response. Therefore, sleeve lobectomy after induction chemoimmunotherapy is safe and feasible.


      Glossary of Abbreviations:

      NSCLC (non-small cell lung cancer), ICI (immune checkpoint inhibitor), CT (computed tomography), PET (positron emission tomography), MPR (major pathological response), pCR (pathological complete response)