ObjectiveTo investigate the impact of the interval between neoadjuvant immunotherapy and surgery on the prognosis of patients with non-small cell lung cancer (NSCLC), and to provide evidence-based guidance for the selection of surgical timing in clinical practice. MethodsClinical data of NSCLC patients who underwent surgery following neoadjuvant immunotherapy at the First Hospital of Lanzhou University from October 2020 to May 2022 were retrospectively collected. According to the interval between the last neoadjuvant immunotherapy and surgery, patients were stratified into three groups using cutoff values of 4 and 6 weeks: a ≤4 weeks group, a >4-6 weeks group, and a >6 weeks group. The Kaplan-Meier method and Cox proportional hazards model were employed to analyze overall survival (OS) and recurrence-free survival (RFS), while logistic regression was performed to identify independent predictors of major pathologic response (MPR). ResultsA total of 165 patients were finally enrolled, comprising 143 (86.67%) males and 22 (13.33%) females, with a median age of 65.00 years. The ≤4 weeks, >4-6 weeks, and >6 weeks groups included 33, 80, and 52 patients, respectively, with well-balanced baseline characteristics among the groups. The median follow-up duration was 28.3 months with a follow-up rate of 89.2%. The overall MPR (including pathologic complete response) rate was 55.16%; however, no significant difference in pathological response was observed among the three groups. Kaplan-Meier analysis revealed no obvious separation in OS or RFS among the three groups. Nevertheless, when regrouped using a cutoff of 65 days, the ≤65 days group demonstrated significant survival benefits (OS: P=0.032; RFS: P=0.003). Logistic regression analysis identified squamous cell carcinoma as an independent predictor of MPR (P=0.05). Cox regression analysis showed that receiving ≥3 cycles of neoadjuvant therapy (P=0.01) and postoperative adjuvant therapy (P=0.02) were independent protective factors for OS. ConclusionThe interval between neoadjuvant immunotherapy and surgery of ≤4 weeks, >4-6 weeks, or >6 weeks has no significant effect on surgical safety, pathological response, or long-term prognosis in patients with NSCLC.
With the integration of 5G communication technology and robotic surgical systems, remote robot-assisted thoracic surgery is overcoming geographical barriers, offering an innovative approach to addressing the uneven distribution of medical resources. This study conducted a systematic literature review—using databases such as PubMed and CNKI, with the search period extending up to 2025—incorporating clinical studies, case reports, and review articles to comprehensively evaluate the clinical efficacy and safety of 5G-enabled remote robot-assisted thoracic surgery (5G-RRATS). The analysis also examined current technological limitations and potential future development trajectories. Existing evidence indicates that, given adequate technical support, 5G-RRATS can achieve perioperative outcomes comparable to those of conventional local robotic surgeries across procedures including pulmonary wedge resection, lobectomy, and esophagectomy. Furthermore, it demonstrates potential advantages in minimizing surgical incisions and reducing intraoperative blood loss. Nevertheless, challenges related to network stability, latency control, interdisciplinary collaboration between medical and engineering teams, and legal, regulatory, and ethical considerations continue to hinder widespread clinical adoption. Looking ahead, the emergence of a "one-to-many" remote surgical model, combined with the integration of artificial intelligence and augmented reality technologies, as well as advancements in low-orbit satellite communications, may enable 5G-RRATS to further advance precision and efficiency in thoracic surgery, thereby facilitating equitable access to high-quality care for a broader patient population.