Thoracic Cancer最新文献

{"title":"High-Definition and Autofluorescence Bronchoscopic Imaging for Evaluating Epithelial Changes in Squamous Cell Lung Cancer After Neoadjuvant Immunochemotherapy: A Case Report.","authors":"Kei Morikawa, Koji Kojima, Hideki Marushima, Yoshiya Sugiura, Junki Koike, Hisashi Saji, Masamichi Mineshita","doi":"10.1111/1759-7714.70096","DOIUrl":"10.1111/1759-7714.70096","url":null,"abstract":"<p><p>In recent years, perioperative immune checkpoint inhibitors have become indicated for early-stage lung cancer, emphasizing the importance of high-resolution endoscopic evaluation of preoperative drug therapy. At the initial evaluation, a male patient in his 60s presented with a primary lesion obstructing the right upper lobe bronchus. After three courses of neoadjuvant immunochemotherapy, chest computed tomography and endoscopic examinations showed a near-complete response. Narrow-band imaging indicated that subepithelial vascular regularity and distribution patterns were within normal limits. However, autofluorescence imaging (AFI) revealed a magenta-colored area on the bronchial epithelium corresponding to the initial lesion site. Two months later, the magenta coloration faded, suggesting pathological normalization of the bronchial epithelium thickening. AFI enabled visualization of tumor progression in the bronchi otherwise completely obstructed by the lesion, potentially offering valuable information to determine bronchial resection lines during surgery.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 10","pages":"e70096"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Analysis of Treatment Patterns in Limited-Stage Small Cell Lung Cancer: Implications for Clinical Practice.","authors":"Siyuan Yu, Xiaoyi Feng, Shengjie Li, Xiaoyan Liu, Xiaoxing Gao, Minjiang Chen, Jing Zhao, Wei Zhong, Yan Xu, Mengzhao Wang","doi":"10.1111/1759-7714.70070","DOIUrl":"https://doi.org/10.1111/1759-7714.70070","url":null,"abstract":"<p><strong>Background: </strong>Unresolved issues complicate treating limited-stage small-cell lung cancer (LS-SCLC). We conducted a real-world study analyzing LS-SCLC treatment patterns to address clinical needs.</p><p><strong>Methods: </strong>We retrospectively enrolled patients with LS-SCLC treated at Peking Union Medical College Hospital between May 2008 and December 2023. Information was collected on clinicopathological features, cancer-related treatments, laboratory test results, and clinical and prognostic data. Kaplan-Meier survival analysis was performed to evaluate progression-free (PFS) and overall survival (OS). Cox regression models were used to assess the factors influencing survival.</p><p><strong>Results: </strong>Among the 203 patients with LS-SCLC, the median OS (mOS) was 28.8 months. Log-rank testing revealed significant mOS differences among radiotherapy timing groups (p = 0.031): concurrent chemoradiotherapy (cCRT) 30.1 months, sequential therapy 27.5 months, and no radiotherapy 21.7 months. Early cCRT showed a non-significant mOS trend advantage over late cCRT (38.3 vs. 29.5 months, p = 0.058). Prophylactic cranial irradiation (PCI) demonstrated comparable mOS (36.9 vs. 29.6 months, p = 0.27). Peripheral blood biomarkers (PBBs) lacked prognostic significance. Multivariate analysis identified Eastern Cooperative Oncology Group (ECOG) performance status (PS) > 1 (HR = 3.652, 95% CI 1.579-8.448; p = 0.002) and N2/N3 metastasis (N2: HR = 2.872, 95% CI 1.312-6.286, p = 0.008; N3: HR = 2.645, 95% CI 1.195-5.856, p = 0.016) as survival predictors. Sequential radiotherapy increased mortality risk versus early cCRT (HR = 1.701, 95% CI 1.125-2.573; p = 0.012).</p><p><strong>Conclusions: </strong>Performance status and lymph node metastasis are prognostic factors for patients with LS-SCLC. cCRT improves the prognosis of LS-SCLC, with early cCRT providing a significant survival benefit and late cCRT being an acceptable option.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 9","pages":"e70070"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desensitizing Effect of Intra-Tumoral GDF-15 on Immunotherapy in Patients With Advanced Non-Small Cell Lung Cancer.","authors":"Naoya Nishioka, Tateaki Naito, Takashi Sugino, Koji Muramatsu, Shigeki Nishihara, Hiroki Urashima, Nobuaki Mamesaya, Haruki Kobayashi, Shota Omori, Ryo Ko, Kazushige Wakuda, Akira Ono, Hirotsugu Kenmotsu, Haruyasu Murakami, Toshiaki Takahashi","doi":"10.1111/1759-7714.70089","DOIUrl":"10.1111/1759-7714.70089","url":null,"abstract":"<p><strong>Background: </strong>Serum growth/differentiation factor 15 (GDF-15) suppresses anti-tumor immunity and predicts prognosis in several malignancies. Elevated GDF-15 levels are linked to cancer cachexia, characterized by weight loss and systemic inflammation, adversely affecting patient outcomes and therapy response. However, serum GDF-15 is not always derived from tumor tissues but also from multiple organs. Therefore, we evaluated whether intra-tumoral GDF-15 could be used as a biomarker for immunotherapy and its potential association with cancer cachexia.</p><p><strong>Method: </strong>We retrospectively evaluated patients with advanced non-small cell lung cancer (NSCLC) who underwent treatment with programmed cell death-1 (PD-1)/programmed cell death-ligand 1 (PD-L1) inhibitors at the Shizuoka Cancer Center between 2017 and 2021. Patients with histologically confirmed NSCLC (stage III-IV or postoperative recurrence) who had undergone biopsy or surgery within 6 months prior to initiating immunotherapy were included. Expression of tumor-derived GDF-15 was evaluated using immunohistochemical staining of archival biopsy and surgical specimens. We analyzed the correlation between intra-tumoral GDF-15 expression and the incidence of cancer cachexia, as well as its impact on progression-free survival (PFS) and overall survival (OS).</p><p><strong>Result: </strong>In 6 of 35 cases, tumor cells highly expressed GDF-15. Patients with high intra-tumoral GDF-15 expression had a higher incidence of cancer cachexia (100% vs. 41.4%, p < 0.05), shorter PFS (3.4 vs. 13.4 months, p < 0.05), and shorter OS (9.5 vs. 26.5 months, p < 0.05) than those with low intra-tumoral GDF-15 expression.</p><p><strong>Conclusion: </strong>Intra-tumoral GDF-15 expression may predict the presence of cancer cachexia and the efficacy of PD-1/PD-L1 inhibitors in patients with advanced non-small cell lung cancer.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 10","pages":"e70089"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracoscopic Massive Bleeding After Firing Mediastinal Trunk of the Pulmonary Artery With Calcified Lymph Node.","authors":"Alfonso Fiorelli, Beatrice Leonardi, Maria Marvulli, Francesca Capasso, Vincenzo Di Filippo, Francesco Coppolino, Giovanni Vicidomini","doi":"10.1111/1759-7714.70092","DOIUrl":"10.1111/1759-7714.70092","url":null,"abstract":"<p><p>The thoracoscopic management of hilar calcified lymph nodes is a technical challenge as the dense adhesions with the bronchus and vessels prevented a safe dissection. Herein, we reported the unexpected bleeding after firing the mediastinal trunk of the pulmonary artery with calcified lymph nodes during the completion of thoracoscopic right upper lobectomy for the management of lung cancer. The bleeding was successfully fixed by an emergent thoracotomy. We used a standard white vascular cartridge that probably was unable to staple a thick tissue, such as the vessel with calcified lymph node. Thus, the best strategy remained to cut the pulmonary artery where the lymph nodes were not attached, and the plasty of the pulmonary artery should be considered if the lymph nodes could not be dissected from the vessels. If the surgeons were not confident to manage this situation under thoracoscopy, conversion to thoracotomy should never be forgotten. Open surgery could facilitate the dissection of calcified lymph nodes and safely fix unexpected bleeding due to vascular lesions.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 10","pages":"e70092"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image-Based Deep Learning Model for Predicting Lymph Node Metastasis in Lung Adenocarcinoma With CT ≤ 2 cm.","authors":"Shang Liu, Zhen Gao, Li-Feng Shi, Han Xiao, Su Li, Meng Li, Zhong-Min Peng","doi":"10.1111/1759-7714.70048","DOIUrl":"https://doi.org/10.1111/1759-7714.70048","url":null,"abstract":"<p><strong>Background: </strong>Lymph node metastasis (LNM) poses a considerable threat to survival in lung adenocarcinoma. Currently, minor resection is the recommended surgical approach for small-diameter lung cancer. The accurate preoperative identification of LNM in patients with small-diameter lung cancer is important for improving patient survival and outcomes.</p><p><strong>Methods: </strong>A total of 1740 patients with clinical early-stage lung adenocarcinoma who underwent surgical resection were enrolled in this study. The Lasso model was used to screen clinical and imaging features, and multivariate logistic regression analysis was used to analyze the relevant diagnostic factors to establish a diagnostic model for predicting LNM. Receiver operating characteristic (ROC) curve analysis, decision curve analysis (DCA) and calibration curve analysis were used to verify the clinical efficacy of the model, which was further validated with an internal validation set.</p><p><strong>Results: </strong>The proportion of solid components (PSC), sphericity, nodule margin, entropy, and edge blur were identified as diagnostic factors that were strongly correlated with LNM in lung adenocarcinoma patients. The area under the ROC curve (AUC) in the internal training set was 0.91. Decision curve analysis revealed that the model could achieve greater benefits for patients. The calibration curve was used to further verify the applicability of the prediction model.</p><p><strong>Conclusions: </strong>Patients with early-stage lung adenocarcinoma with LNM can be identified by typical imaging features. The diagnostic model can help to optimize surgical planning among thoracic surgeons.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 10","pages":"e70048"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysbiosis in the Gut Microbiome of Pembrolizumab-Treated Non-Small Lung Cancer Patients Compared to Healthy Controls Characterized Through Opportunistic Sampling.","authors":"Haris Charalambous, Cameron Brown, Paris Vogazianos, Kyriaki Katsaounou, Elpiniki Nikolaou, Ioannis Stylianou, Elisavet Papageorgiou, Dimitris Vraxnos, Aristos Aristodimou, Jianxiang Chi, Paul Costeas, Christos Shammas, Yiorgos Apidianakis, Athos Antoniades","doi":"10.1111/1759-7714.70075","DOIUrl":"10.1111/1759-7714.70075","url":null,"abstract":"<p><strong>Background: </strong>The gut microbiome influences the host immune system, cancer development and progression, as well as the response to immunotherapy during cancer treatment. Here, we analyse the composition of the gut bacteriome in metastatic Non-Small Cell Lung Cancer (NSCLC) patients receiving Pembrolizumab immunotherapy within a prospective maintenance trial through opportunistic sampling during treatment.</p><p><strong>Methods: </strong>The gut microbiome profiles of NSCLC patients were obtained from stool samples collected during Pembrolizumab treatment and analysed with 16S rRNA metagenomics sequencing. Patient profiles were compared to a group of healthy individuals of matching ethnic group, age, sex, BMI and comorbidities.</p><p><strong>Results: </strong>A significant decrease in the treated patients was observed in two prominent bacterial families of the phylum Firmicutes, Lachnospiraceae and Ruminoccocaceae, which comprised 31.6% and 21.8% of the bacteriome in the healthy group but only 10.9% and 14.2% in the treated patient group, respectively. Species within the Lachnospiraceae and Ruminococcaceae families are known to break down undigested carbohydrates generating short chain fatty acids (SCFA), such as butyrate, acetate and propionate as their major fermentation end-products, which have been implicated in modifying host immune responses. In addition, a significant increase of the Bacteroidacaeae family (Bacteroidetes phylum) was observed from 10.7% in the healthy group to 23.3% in the treated patient group. Moreover, and in agreement with previous studies, a decrease in the Firmicutes to Bacteroidetes ratio in the metastatic NSCLC Pembrolizumab-treated patients was observed.</p><p><strong>Conclusion: </strong>The observed differences indicate dysbiosis and a compromised intestinal health status in the metastatic NSCLC Pembrolizumab-treated patients. This data could inform future studies of immunotherapy treatment responses and modulation of the gut microbiome to minimise dysbiosis prior or concurrent to treatment.</p><p><strong>Trial registration: </strong>SWIPE Trial (NCT02705820).</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 9","pages":"e70075"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"IFI30 Knockdown Inhibits ESCC Progression by Promoting Apoptosis and Senescence via Activation of JNK and P21/P16 Pathways\".","authors":"","doi":"10.1111/1759-7714.70087","DOIUrl":"10.1111/1759-7714.70087","url":null,"abstract":"","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 10","pages":"e70087"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NAT10 Knockdown Improves Cisplatin Sensitivity in Non-Small Cell Lung Cancer by Inhibiting the TRIM44/PI3K/AKT Pathway.","authors":"Qi Sun, Xiansong Yang, Ye Wang, Kejia Yang, Yuan Weng","doi":"10.1111/1759-7714.70079","DOIUrl":"https://doi.org/10.1111/1759-7714.70079","url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related deaths worldwide, and cisplatin (DDP) resistance remains a significant challenge in NSCLC treatment.</p><p><strong>Methods: </strong>Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to analyze NAT10 and tripartite motif containing 44 (TRIM44) mRNA levels. Western blotting assay was used to detect protein expression. Cell viability was analyzed by a cell counting kit-8 assay. Cell proliferation, apoptosis, invasion, and stem-like traits were assessed using a 5-Ethynyl-2'-deoxyuridineassay, flow cytometry, Transwell invasion assay, and sphere formation assay, respectively. The association between NAT10 and TRIM44 was identified by an RNA immunoprecipitation assay. A xenograft mouse model was established to evaluate the effect of NAT10 silencing on DDP sensitivity in vivo.</p><p><strong>Results: </strong>NAT10 expression was upregulated in DDP-resistant NSCLC tissues and cells. NAT10 knockdown enhanced DDP sensitivity in DDP-resistant NSCLC cells, accompanied by decreased protein expression of multidrug resistance 1 (MDR1). The silencing of NAT10 also inhibited the proliferation, invasion, and stem-like traits of DDP-resistant NSCLC cells, while inducing cell apoptosis. However, NAT10 overexpression displayed the opposite effects. Moreover, NAT10 maintained TRIM44 mRNA stability in an ac4C-dependent manner. TRIM44 overexpression reversed the NAT10 knockdown-induced effects on DDP sensitivity and the malignant progression of NSCLC cells. In addition, NAT10 silencing inactivated the PI3K/AKT pathway by regulating TRIM44 in DDP-resistant NSCLC cells. The treatment of the PI3K/AKT pathway inhibitor, LY294002, mitigated the effects of TRIM44 overexpression on DDP sensitivity and NSCLC cell progression. Further, NAT10 knockdown improved the sensitivity of tumors to DDP in vivo.</p><p><strong>Conclusion: </strong>NAT10 knockdown improved DDP sensitivity in NSCLC by inhibiting the TRIM44/PI3K/AKT pathway, which may have significant clinical implications for overcoming DDP resistance in NSCLC treatment.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 9","pages":"e70079"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, Regional, and National Burden of Breast Cancer, 1990-2021, and Projections to 2050: A Systematic Analysis of the Global Burden of Disease Study 2021.","authors":"Tong Deng, Hao Zi, Xing-Pei Guo, Li-Sha Luo, Ya-Long Yang, Jin-Xuan Hou, Rui Zhou, Qian-Qian Yuan, Qing Liu, Qiao Huang, Gao-Song Wu","doi":"10.1111/1759-7714.70052","DOIUrl":"https://doi.org/10.1111/1759-7714.70052","url":null,"abstract":"<p><strong>Background: </strong>This study analyzes the global burden of breast cancer (BC) over the past 30 years, identifies key risk factors, and projects future incidence and mortality through 2050.</p><p><strong>Methods: </strong>Data were sourced from the 2021 Global Burden of Disease (GBD) database. The estimated annual percentage change (EAPC) was used to assess trends, and country development was measured using the Socio-Demographic Index (SDI). Projections were conducted using Bayesian age-period-cohort and autoregressive integrated moving average models.</p><p><strong>Results: </strong>In 2021, approximately 2.12 million new breast cancer cases and 674 199 deaths were recorded globally. From 1990 to 2021, incidence and prevalence increased, while mortality and disability-adjusted life years (DALYs) declined overall. Regional and national variations were observed, alongside age and gender differences in the disease burden. A diet high in red meat and a high body mass index were the leading global risk factors for breast cancer deaths. The BC burden was positively correlated with SDI across 21 GBD regions. Decomposition analysis highlighted demographic factors as the main drivers of increased disease burden over the past three decades. Projections indicate that BC incidence will continue to rise through 2050.</p><p><strong>Conclusions: </strong>While global BC mortality has decreased over the past 30 years, incidence continues to rise. Low-SDI regions face increasing challenges, as incidence, mortality, and DALYs persistently climb. These findings underscore the need for targeted public health strategies and equitable resource distribution to mitigate the rising burden of breast cancer.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 9","pages":"e70052"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Significance, Radiological, and Metabolic Characteristics of Metastatic Lymph Nodes in Resectable Non-Small Cell Lung Cancer Following Neoadjuvant Chemoimmunotherapy.","authors":"Tianxiao Han, Sida Cheng, Xun Wang, QingYi Qi, Jinchuan Chen, Wenxiang Wang, Jian Zhou, Yun Li, Kezhong Chen, Hao Li, Fan Yang","doi":"10.1111/1759-7714.70073","DOIUrl":"https://doi.org/10.1111/1759-7714.70073","url":null,"abstract":"<p><strong>Background: </strong>Metastatic lymph nodes (mLNs) exhibit different responses to neoadjuvant immunotherapy compared to the primary tumor (PT) in non-small cell lung cancer (NSCLC). Evaluating mLNs' response is crucial for predicting treatment efficacy and prognosis; however, such assessments are currently insufficient.</p><p><strong>Methods: </strong>We enrolled 101 NSCLC patients with mLNs who underwent neoadjuvant chemoimmunotherapy followed by surgery. Survival outcomes and radiological and metabolic changes were analyzed across different lymph node pathological response groups, and a least absolute shrinkage and selection operator (LASSO) logistic regression model was developed to predict mLNs' response. RNA sequencing was performed to characterize the immune microenvironment of lymph nodes with different pathological responses.</p><p><strong>Results: </strong>Residual tumors in mLNs were significantly associated with worse recurrence-free survival (p = 0.003) and a trend toward worse overall survival (p = 0.087). Combining the pathological responses of mLNs and PTs improved prognostic stratification. Neither radiological size changes (AUC: 0.621) nor the SUVmax reduction rate (AUC: 0.645) were effective in distinguishing mLNs response. A model combining radiological and metabolic parameters demonstrated fair prediction efficacy (AUC: 0.85). In separate analyses of N1 and N2 nodes, radiological and metabolic changes of N1 mLNs partly reflected their pathologic response (AUC: 0.734; 0.816), unlike in N2 mLNs. RNA sequencing revealed that immune infiltration in responding lymph nodes differed from non-responding ones, with higher CD8+ T cells, NK T cells, B cells, and dendritic cells in the former.</p><p><strong>Conclusion: </strong>The pathological response of mLNs provides additional prognostic information, but current tools are ineffective for detecting residual tumors. A model integrating radiological and metabolic parameters may offer better prediction.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 9","pages":"e70073"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}