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Among 144 participants, DLN count ≤16 corresponded to superior progression-free survival compared with higher counts across primary, validation, and entire cohorts. The negative prognostic effect of higher DLN count was strongest in the immunotherapy-alone subgroup, with added associations involving CD8+ central memory T cells within LNs. Results support a precise, immune-depending lymphadenectomy strategy when adjuvant immunotherapy is planned.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/impact-of-lymphadenectomy-extent-on-immunotherapy-efficacy-in-postresectional-recurred-non-small-cell-lung-cancer-a-multi-institutional-retrospective-cohort-study/331793/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/impact-of-lymphadenectomy-extent-on-immunotherapy-efficacy-in-postresectional-recurred-non-small-cell-lung-cancer-a-multi-institutional-retrospective-cohort-study/331793.png","ImageObject",300,407,{"name":92,"@type":93},"Jiven","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What was the main purpose of the study?","Question",{"text":113,"@type":114},"To evaluate how the extent of lymph node dissection, measured by DLN count, affects the efficacy of anti-PD-1 immunotherapy in recurrent postresectional non-small cell lung cancer, and to suggest an immunotherapy-driven dissection strategy.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were patients grouped in the analysis?",{"text":118,"@type":114},"Patients receiving anti-PD-1 immunotherapy for recurrence from 2018 to 2020 were stratified by DLN count, using a cutoff of 16 (≤16 vs >16).",{"name":120,"@type":111,"acceptedAnswer":121},"What did DLN count show regarding progression-free survival?",{"text":122,"@type":114},"DLN count ≤16 was associated with improved progression-free survival across primary, validation, and entire cohorts in multivariable Cox analysis. Higher DLN count (cutoff 16) correlated with poorer immunotherapy efficacy, especially in the immunotherapy-alone subgroup.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},331793,1791006588,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},1099513958607,"https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399","’Retrospective Cohort Study  \nImpact of lymphadenectomy extent on immunotherapy efficacyin postresectional recurred non-small cell lung cancer: a multi-institutional retrospective cohort study  \nHongsheng Deng, MDa, Juan Zhou, MDb, Hualin Chen, MDc, Xiuyu Cai, MDd, Ran Zhong, MDa, Feng Li, MDa, Bo Cheng, MDa, Caichen Li, MDa, Qingzhu Jia, MDe, Caicun Zhou, MDb, RenéH. Petersen, MDf, Gaetano Rocco, MDg, Alex Brunelli, MDh, Calvin S. H. Ng, MDi, Thomas A. D’Amico, MDj, Chunxia Su, MDb,* , Jianxing He, MD, PhDa,* , Wenhua Liang, MDa,* , Bo Zhu, MDe, on behalf of the AME Thoracic Surgery Collaborative Group  \nBackground: Lymph node (LN) dissection is a common procedure for non-small cell lung cancer (NSCLC) to ascertain disease severity and treatment options. However, murine studies have indicated that excising tumor-draining LNs diminished immunotherapy effectiveness, though its applicability to clinical patients remains uncertain. Hence, the authors aim to illustrate the immunological implications of LN dissection by analyzing the impact of dissected LN (DLN) count on immunotherapy efficacy, and to propose a novel ‘immunotherapy-driven ’ LN dissection strategy.  \nMaterials and methods: The authors conducted a retrospective analysis of NSCLC patients underwent anti-PD-1 immunotherapy for recurrence between 2018 and 2020, assessing outcomes based on DLN count stratification.  \nResults: A total of 144 patients were included, of whom 59 had a DLN count less than or equal to 16 (median, IQR: 11, 7–13); 66 had a DLN count greater than 16 (median, IQR: 23, 19–29) . With a median follow-up time of 14 .3 months (95% CI: 11 .0–17.6), the overall median progression-free survival (PFS) was 7 .9 (95% CI: 4 .1–11.7) months, 11 .7 (95% CI: 7 .9–15.6) months in the combination therapy subgroup, and 4 .8 (95% CI: 3 .1–6.4) months in the immunotherapy alone subgroup, respectively. In multivariable Cox analysis, DLN count less than or equal to 16 is associated with an improved PFS in all cohorts [primary cohort:  \nHR = 0.26 (95% CI: 0 .07–0.89), P = 0.03]; [validation cohort: HR = 0.46 (95% CI: 0 .22–0.96), P = 0.04]; [entire cohort: HR = 0.53 (95% CI: 0 .32–0.89), P = 0.02] . The prognostic benefit of DLN count less than or equal to 16 was more significant in immunotherapy alone, no adjuvant treatment, pN1, female, and squamous carcinoma subgroups. A higher level of CD8 + central memory T cell (Tcm) within LNs was associated with improved PFS (HR: 0 .235, 95% CI: 0 .065–0.845, P = 0.027) .  \nConclusions: An elevated DLN count (cutoff: 16) was associated with poorer immunotherapy efficacy in recurrent NSCLC, especially pronounced in the immunotherapy alone subgroup. CD8+Tcm proportions in LNs may also impact immunotherapy efficacy. Therefore, for patients planned for adjuvant immunotherapy, a precise rather than expanded lymphadenectomy strategy topreserve immune-depending LNs is recommended.  \nKeywords: immunotherapy, lymph node dissection, non-small cell lung cancer, PD-1 blockade, postresectional recurrence  \naDepartment of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China, bDepartment of Medical Oncology, Shanghai Pulmonary Hospital and Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China, cDepartment of Pulmonary Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China, dDepartment of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China, eInstitute of Cancer, Xinqiao Hospital, The Army Medical University, Chongqing, China, fDepartment of Cardiothoracic Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark, gThoracic Service, Department of Surgery, Memo","cbCaikoGsYYDtIh8","https://ap.wps.com/l/cbCaikoGsYYDtIh8","pdf",1220368,15,"English","# Background\n## Materials and methods\n## Results\n## Conclusions\n# Keywords","[{\"question\":\"What was the main purpose of the study?\",\"answer\":\"To evaluate how the extent of lymph node dissection, measured by DLN count, affects the efficacy of anti-PD-1 immunotherapy in recurrent postresectional non-small cell lung cancer, and to suggest an immunotherapy-driven dissection strategy.\"},{\"question\":\"How were patients grouped in the analysis?\",\"answer\":\"Patients receiving anti-PD-1 immunotherapy for recurrence from 2018 to 2020 were stratified by DLN count, using a cutoff of 16 (≤16 vs \\u003e16).\"},{\"question\":\"What did DLN count show regarding progression-free survival?\",\"answer\":\"DLN count ≤16 was associated with improved progression-free survival across primary, validation, and entire cohorts in multivariable Cox analysis. Higher DLN count (cutoff 16) correlated with poorer immunotherapy efficacy, especially in the immunotherapy-alone subgroup.\"}]","Impact of lymphadenectomy extent on immunotherapy efficacy in postresectional recurred non-small cell lung cancer - a multi-institutional retrospective cohort study | PDF",1789995187,38]