{
  "abstract": "Surgical de-escalation holds promise for non-small cell lung cancer (NSCLC) following neoadjuvant chemoimmunotherapy (NACI), but evidence remains scarce. We aimed to assess the safety and clinical outcomes of surgical de-escalation following NACI in central NSCLC. A dual-center retrospective cohort study included 166 patients with locally advanced central NSCLC who received NACI followed by curative surgical resection. Patients were stratified into modified (surgical de-escalation) and unmodified groups. Propensity score matching (PSM) was performed to balance baseline covariates, with standardized mean difference ≤0.1 indicating optimal balance. Primary endpoint comprised event-free survival (EFS), and Secondary endpoints included overall survival (OS), recurrence-free survival (RFS), local recurrence-free survival (LRFS), and health-related quality of life (HRQoL). Survival outcomes were analyzed using the Kaplan-Meier method and Cox proportional hazards regression to estimate hazard ratios (HR) and confidence intervals (CIs). At a median follow-up of 33.9 months, the modified surgery group showed superior 3-year EFS (75.2% vs. 63.4%, HR =0.56, P=0.04) and RFS (73.6% vs. 64.3%, HR =0.51, P=0.03) in the unmatched cohort. After PSM, EFS, RFS, and OS were comparable (all P>0.05); nevertheless, the modified surgery group demonstrated a significantly higher risk of local recurrence (HR =5.39, 95% CI: 1.18-24.61, P=0.03). The incidences of perioperative complications and postoperative dyspnea were consistently lower in the modified group before and after PSM (all P<0.05). For carefully selected central NSCLC patients, surgical de-escalation following NACI was associated with lower postoperative dyspnea scores and yielded comparable oncological outcomes. Rigorous surveillance is warranted due to the heightened risk of local recurrence.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.",
    "Thoracic Oncology Institute, Peking University People's Hospital, Beijing, China.",
    "Research Unit of Intelligence Diagnosis and Treatment in Early Non-small Cell Lung Cancer, Chinese Academy of Medical Sciences, Peking University People's Hospital, Beijing, China.",
    "Institute of Advanced Clinical Medicine, Peking University, Beijing, China.",
    "Beijing Key Laboratory of Innovative Application of Big Data in Lung Cancer, Peking University People's Hospital, Beijing, China.",
    "Department of Thoracic Surgery, Air Force Medical University Tangdu Hospital, Xi'an, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1,
        2,
        3,
        4
      ],
      "name": "Yulong Wang"
    },
    {
      "affs": [
        5
      ],
      "name": "Bengang Hui"
    },
    {
      "affs": [
        0,
        1,
        2,
        3,
        4
      ],
      "name": "Xin Wang"
    },
    {
      "affs": [
        0,
        1,
        2,
        3,
        4
      ],
      "name": "Guihu Lin"
    },
    {
      "affs": [
        0,
        1,
        2,
        3,
        4
      ],
      "name": "Xun Wang"
    },
    {
      "affs": [
        0,
        1,
        2,
        3,
        4
      ],
      "name": "Xiao Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0dh88wq1m6xr5.bib",
  "cited_by": 0,
  "doi": "10.21037/tlcr-2026-0911",
  "fulltext_url": "https://europepmc.org/articles/PMC13743463",
  "id": "0dh88wq1m6xr5",
  "issns": [
    "2218-6751",
    "2226-4477"
  ],
  "landing_url": "https://europepmc.org/article/MED/42999650",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Lung Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7223803808",
  "pdf_url": "https://europepmc.org/articles/PMC13743463?pdf=render",
  "pmcid": "PMC13743463",
  "pmid": "42999650",
  "published": "2026-09-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/0dh88wq1m6xr5.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42999650",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42999650"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2730|Lung Cancer Research Studies",
      "subfield": "oncology"
    }
  ],
  "title": "Surgical de-escalation strategies for non-small cell lung cancer following neoadjuvant chemoimmunotherapy: a propensity score-matched analysis.",
  "title_text": "Surgical de-escalation strategies for non-small cell lung cancer following neoadjuvant chemoimmunotherapy: a propensity score-matched analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/0dh88wq1m6xr5",
  "venue": "Translational lung cancer research",
  "versions": []
}