Scholarlink

Background <p>Adjuvant chemoimmunotherapy has recently become a standard treatment for pathological stage II–III non-small cell lung carcinoma (NSCLC). However, recent basic studies have suggested that lymph node (LN) dissection could attenuate the effect of adjuvant chemoimmunotherapy. We investigated the efficacy of adjuvant chemoimmunotherapy versus chemotherapy and the impact of lymph node dissection.</p> Patients and Methods <p>Using the National Cancer Database, patients diagnosed with pathological stage II–III NSCLC in 2021 who underwent adjuvant therapy were analyzed. The primary outcome was overall survival (OS) analyzed using the Kaplan–Meier method and multivariable Cox regression models. Propensity score matching (PSM) was performed to conduct a sensitivity analysis.</p> Results <p>We identified 3229 and 926 patients who received adjuvant chemotherapy alone and adjuvant chemoimmunotherapy, respectively. Multivariable Cox regression analysis showed adjuvant chemoimmunotherapy significantly improved OS compared with adjuvant chemotherapy alone (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.59–0.88; <i>p</i> = 0.0010). After PSM, multivariable regression analyses indicated that adjuvant chemoimmunotherapy significantly improved OS in the high-LN dissection group (number of dissected LNs ≥ 20) (hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.37–0.99; <i>p</i> = 0.0450), although there were no significant differences in OS between the low-LN dissection (number of dissected LNs, 0–9) (HR, 0.74; 95% CI 0.48–1.14; <i>p</i> = 0.1701) and intermediate-LN dissection (number of dissected LNs, 10–19) (HR, 0.74; 95% CI 0.52–1.04; <i>p</i> = 0.0799) groups.</p> Conclusions <p>Our results suggest that the efficacy of adjuvant chemoimmunotherapy for NSCLC is not attenuated by LN dissection.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Efficacy of Adjuvant Chemoimmunotherapy versus Chemotherapy and the Impact of Lymph Node Dissection on Survival

  • 期刊论文

  • 发表日期：

    2026年5月19日

查看全文
  • Asato Hashinokuchi,
  • Shinkichi Takamori,
  • Junjia Zhu,
  • Hoang Hannah,
  • Mototsugu Shimokawa,
  • Masafumi Yamaguchi,
  • Takefumi Komiya

摘要

Background

Adjuvant chemoimmunotherapy has recently become a standard treatment for pathological stage II–III non-small cell lung carcinoma (NSCLC). However, recent basic studies have suggested that lymph node (LN) dissection could attenuate the effect of adjuvant chemoimmunotherapy. We investigated the efficacy of adjuvant chemoimmunotherapy versus chemotherapy and the impact of lymph node dissection.

Patients and Methods

Using the National Cancer Database, patients diagnosed with pathological stage II–III NSCLC in 2021 who underwent adjuvant therapy were analyzed. The primary outcome was overall survival (OS) analyzed using the Kaplan–Meier method and multivariable Cox regression models. Propensity score matching (PSM) was performed to conduct a sensitivity analysis.

Results

We identified 3229 and 926 patients who received adjuvant chemotherapy alone and adjuvant chemoimmunotherapy, respectively. Multivariable Cox regression analysis showed adjuvant chemoimmunotherapy significantly improved OS compared with adjuvant chemotherapy alone (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.59–0.88; p = 0.0010). After PSM, multivariable regression analyses indicated that adjuvant chemoimmunotherapy significantly improved OS in the high-LN dissection group (number of dissected LNs ≥ 20) (hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.37–0.99; p = 0.0450), although there were no significant differences in OS between the low-LN dissection (number of dissected LNs, 0–9) (HR, 0.74; 95% CI 0.48–1.14; p = 0.1701) and intermediate-LN dissection (number of dissected LNs, 10–19) (HR, 0.74; 95% CI 0.52–1.04; p = 0.0799) groups.

Conclusions

Our results suggest that the efficacy of adjuvant chemoimmunotherapy for NSCLC is not attenuated by LN dissection.