Successful Video-Assisted Thoracoscopic Surgery Following Neoadjuvant Chemoimmunotherapy for Stage IIIB Central Squamous Cell Lung Cancer: A Case Report
https://doi.org/10.35401/2541-9897-2025-10-2-112-118
Abstract
When surgical treatment is limited in patients with stage IIIA-IIIB non–small cell lung cancer (NSCLC), multimodality treatment can improve long-term outcomes: neoadjuvant chemotherapy to reduce the tumor size followed by radical surgery.
In recent years, the combination of standard induction chemotherapy with immune checkpoint inhibitors has been the subject of active debate in the literature. Some studies demonstrate the efficacy of neoadjuvant chemoimmunotherapy, whereas other authors note additional difficulties of surgery after it.
In this case report we demonstrate features of surgery in a male patient with stage IIIB central NSCLC after chemoimmunotherapy and discuss difficulties of surgery associated with a minimally invasive video-assisted thoracoscopic surgery approach in complex anatomical lung resection and methods for preventing intraoperative and postoperative complications.
About the Authors
E. I. Zinchenko
Saint Petersburg State University; Sokolov Northwestern District Research and Clinical Center
Russian Federation
Russian Federation
Evgenii I. Zinchenko - Cand. Sci. (Med.), Associate Professor at the Hospital Surgery Department, Saint Petersburg State University; Thoracic Surgeon, Thoracic Surgery Center, Sokolov North-western District Research and Clinical Center.
Saint Petersburg
A. S. Petrov
Saint Petersburg State University; Sokolov Northwestern District Research and Clinical Center
Russian Federation
Russian Federation
Andrey S. Petrov - Cand. Sci. (Med.), Associate Professor at the Hospital Surgery Department, Saint Petersburg State University; Thoracic Surgeon, Thoracic Surgery Center, Sokolov North-western District Research and Clinical Center.
Saint Petersburg
D. L. Fateeva
Saint Petersburg State University
Russian Federation
Russian Federation
Daria L. Fateeva - Thoracic Surgery Resident, Hospital Surgery Department, Saint Petersburg State University.
Universitetskaya naberezhnaya 7-9, Saint Petersburg, 199034
V. G. Pischik
Saint Petersburg State University; Sokolov Northwestern District Research and Clinical Center; City Clinical Oncological Dispensary; Health Committee of St. Petersburg
Russian Federation
Russian Federation
Vadim G. Pischik - Dr. Sci. (Med.), Professor at the Hospital Surgery Department, Saint Petersburg State University; Head of the Thoracic Surgery Center, Sokolov Northwestern District Research and Clinical Center; Chief Surgeon, City Clinical Oncology Dispensary; Chief Nonstaff Thoracic Surgeon, Health Committee of St. Petersburg.
Saint Petersburg
References
1. Chhikara BS, Parang K. Global Cancer Statistics 2022: the trends projection analysis. Chemical Biology Letters. 2023;10(1):451.
2. Bade BC, Dela Cruz CS. Lung Cancer 2020: epidemiology, etiology, and prevention. Clin Chest Med. 2020;41(1):1–24. PMID: 32008623. https://doi.org/10.1016/j.ccm.2019.10.001
3. Hoy H, Lynch T, Beck M. Surgical treatment of lung cancer. Crit Care Nurs Clin North Am. 2019;31(3):303–313. PMID: 31351552. https://doi.org/10.1016/j.cnc.2019.05.002
4. Girard N, Perol M, Simon G, et al. Treatment strategies for unresectable locally advanced non-small cell lung cancer in the real-life ESME cohort. Lung Cancer. 2021;162:119–127. PMID: 34775215. https://doi.org/10.1016/j.lungcan.2021.10.017
5. Provencio M, Serna-Blasco R, Nadal E, et al. Overall survival and biomarker analysis of neoadjuvant nivolumab plus chemotherapy in operable stage IIIA non-small-cell lung cancer (NADIM phase II trial). J Clin Oncol. 2022;40(25):2924–2933. Published correction appears in J Clin Oncol. 2022;40(32):3785. PMID: 35576508. PMCID: PMC9426809. https://doi.org/10.1200/JCO.21.02660
6. Forde PM, Spicer J, Lu S, et al; CheckMate 816 Investigators. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med. 2022;386(21):1973–1985. PMID: 35403841. PMCID: PMC9844511. https://doi.org/10.1056/NEJMoa2202170
7. Bott MJ, Yang SC, Park BJ, et al. Initial results of pulmonary resection after neoadjuvant nivolumab in patients with resectable non-small cell lung cancer. J Thorac Cardiovasc Surg. 2019;158(1):269–276. PMID: 30718052. PMCID: PMC6653596. https://doi.org/10.1016/j.jtcvs.2018.11.124
8. Tong BC, Gu L, Wang X, et al. Perioperative outcomes of pulmonary resection after neoadjuvant pembrolizumab in patients with non-small cell lung cancer. J Thorac Cardiovasc Surg. 2022;163(2):427–436. PMID: 33985811. https://doi.org/10.1016/j.jtcvs.2021.02.099
9. Zhao R, Guan X, Zhang P, et al. Development of postoperative bronchopleural fistula after neoadjuvant immunochemotherapy in non-small cell lung cancer: case reports and review of the literature. J Cancer Res Clin Oncol. 2024;150(4):175. PMID: 38573518. PMCID: PMC10995031. https://doi.org/10.1007/s00432-024-05683-9
10. Petrov AS, Atyukov MA, Zhemchugova OA, Zemtsova IJu, Yanchii MN, Yablonskiy PK. Case of successfull treatment of squamous-cell carcinoma IIIA (immunotherapy+surgical resection), followed by VATS S6 segmentectomy for metachronous squamous-cell carcinoma IA in contralateral lung. Problems in Oncology. 2020;66(3):291–295. (In Russ.). https://doi.org/10.37469/0507-3758-2020-66-3-291-295
11. Franzi S, Mattioni G, Rijavec E, Croci GA, Tosi D. Neoadjuvant chemo-immunotherapy for locally advanced non-small-cell lung cancer: a review of the literature. J Clin Med. 2022;11(9):2629. PMID: 35566754. PMCID: PMC9099888. https://doi.org/10.3390/jcm11092629
12. El Husseini K, Piton N, De Marchi M, et al. Lung cancer surgery after treatment with anti-PD1/PD-L1 immunotherapy for non-small-cell lung cancer: a case-cohort study. Cancers (Basel). 2021;13(19):4915. PMID: 34638399. PMCID: PMC8508022. https://doi.org/10.3390/cancers13194915
13. Cao C, Guo A, Chen C, Zielinski R, Bott M. Neoadjuvant immunotherapy for patients with non-small cell lung cancer-current evidence. Ann Transl Med. 2020;8(22):1476. PMID: 33313221. PMCID: PMC7729370. https://doi.org/10.21037/atm-20-5026
14. O’Brien M, Paz-Ares L, Marreaud S, et al; EORTC-1416-LCG/ETOP 8-15 – PEARLS/KEYNOTE-091 Investigators. Pembrolizumab versus placebo as adjuvant therapy for completely resected stage IB-IIIA non-small-cell lung cancer (PEARLS/ KEYNOTE-091): an interim analysis of a randomised, triple-blind, phase 3 trial. Lancet Oncol. 2022;23(10):1274–1286. PMID: 36108662. https://doi.org/10.1016/S1470-2045(22)00518-6
15. Brunelli A, Salati M, Rocco G, et al; ESTS Database Committee. European risk models for morbidity (EuroLung1) and mortality (EuroLung2) to predict outcome following anatomic lung resections: an analysis from the European Society of Thoracic Surgeons database. Eur J Cardiothorac Surg. 2017;51(3):490–497. Published correction appears in Eur J Cardiothorac Surg. 2017;51(6):1212. PMID: 27744321. https://doi.org/10.1093/ejcts/ezw319
Review
For citations:
Zinchenko E.I., Petrov A.S., Fateeva D.L., Pischik V.G. Successful Video-Assisted Thoracoscopic Surgery Following Neoadjuvant Chemoimmunotherapy for Stage IIIB Central Squamous Cell Lung Cancer: A Case Report. Innovative Medicine of Kuban. 2025;10(2):112-118. (In Russ.) https://doi.org/10.35401/2541-9897-2025-10-2-112-118
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