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Purpose: Immunotherapy has created a paradigm shift in the treatment of metastatic non-small cell lung cancer (NSCLC), overcoming the therapeutic plateau previously achieved by systemic chemotherapy. There is growing interest in the utility of immunotherapy for patients with resectable NSCLC in the neoadjuvant setting. The present systematic review and meta-analysis aim to provide an overview of the existing evidence, with a focus on pathological and radiological response, perioperative clinical outcomes, and long-term survival. Methods: A systematic review was conducted using electronic databases from their dates of inception to August 2021. Pooled data on pathological response, radiological response, and perioperative outcomes were meta-analyzed where possible. Results: Eighteen publications from sixteen studies were identified, involving 548 enrolled patients who underwent neoadjuvant immunotherapy, of whom 507 underwent surgery. Pathologically, 52% achieved a major pathological response, 24% a complete pathological response, and 20% reported a complete pathological response of both the primary lesion as well as the sampled lymph nodes. Radiologically, 84% of patients had stable disease or partial response. Mortality within 30 days was 0.6%, and morbidities were reported according to grade and frequency. Conclusion: The present meta-analysis demonstrated that neoadjuvant immunotherapy was feasible and safe based on perioperative clinical data and completion rates of surgery within their intended timeframe. The pathological response after neoadjuvant immunotherapy was superior to historical data for patients who were treated with neoadjuvant chemotherapy alone, whilst surgical and treatment-related adverse events were comparable. The limitations of the study included the heterogenous treatment regimens, lack of long-term follow-up, variations in the reporting of potential prognostic factors, and potential publication bias.

Background: This study aimed to identify whether early postoperative shoulder stiffness is associated with improved healing following rotator cuff repair, and if so, how this factor might interact with other factors known to affect rotator cuff repair integrity.Methods: We conducted a retrospective analysis of prospectively collected data from 1,526 primary arthroscopic rotator cuff repairs. Six-week range of motion was assessed to determine shoulder stiffness, and repair integrity was evaluated at 6 months by ultrasound. Multiple logistic regression analysis was used to identify variables that affected retear, and receiver operating characteristic (ROC) curve analysis was used to evaluate predictive thresholds for retear.Results: Tear-size area was the most accurate predictor of retear (area under the curve [AUC] = 0.77; 95% confidence interval [CI] = 0.72 to 0.81), followed by 6-week passive external rotation (AUC = 0.67; 95% CI = 0.63 to 0.72), 6-week passive forward flexion (AUC = 0.67; 95% CI = 0.62 to 0.72), age (AUC = 0.65; 95% CI = 0.60 to 0.70), tear type (partial-thickness versus fullthickness) (AUC = 0.65; 95% CI = 0.61 to 0.69), and hospital type (public versus private) (AUC = 0.43; 95% CI = 0.37 to 0.49). Patients with smaller tears, reduced 6-week passive external rotation, reduced 6-week passive forward flexion, younger age, partial-thickness tears, and operations performed in a private day surgery or hospital setting were more likely to have an intact rotator cuff repair at 6 months. The AUC of this curve was 0.84 (95% CI = 0.80 to 0.87), which indicates that this combination of factors can accurately predict 84% of retears. Reduced range of motion at 6 weeks was associated with improved repair integrity for patients with tears of >1 to 6 cm 2 ; however, this effect was less pronounced in tears of £1 cm 2 or >6 cm 2 .Conclusions: Early postoperative stiffness following arthroscopic single-row, inverted-mattress rotator cuff repair at 6 weeks was associated with an intact repair at 6 months. The protective effects of postoperative stiffness and tear size were additive. The chance of retear in patients with a tear of £1 cm 2 and external rotation of £27°at 6 weeks was 1%, while those with tears of >6 cm 2 and external rotation of >27°had a 40% chance.Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. R etear remains the most common complication of a rotator cuff repair 1 . Previous studies have identified several factors as independent predictors of retear, specifically, larger tear size, patient age, less surgeon experience, public hospital type, and full-thickness tears [2][3][4][5][6][7] .A reduction in shoulder range of motion following surgery, particularly at 6 weeks, is the second-most-common complication of rotator cuff repair surgery 8 and coincides with increasing pain, which is often interpreted by patients as a failure of the repair 9 . Some surgeons recommend secondary capsular release surgery and/or manipulation under...