Optimal timing of surgery in head and neck squamous cell carcinoma after neoadjuvant immunochemotherapy

Objectives: Our goal was to evaluate the influence of the interlude between neoadjuvant immunochemotherapy (NAIC) and surgery on both pathologic responses and surgical outcomes in head and neck squamous cell carcinoma (HNSCC). Methods: Patients undergoing surgery for HNSCC following NAIC were retrospectively enrolled and determined based on the time to surgery (TTS). Impact of TTS on major pathologic response (mPR), pathologic complete response (pCR), surgical complication and 3-year disease free survival (DFS) was evaluated. Results: A total of 356 patients were enrolled. 225 patients (63.2%) achieved a mPR, among whom a pCR was achieved in 104 patients (29.2%). When compared to the TTS3 weeks group bore an additional 0.67-fold risk of experiencing surgical complications and 1.23-fold increased risk of adverse recurrence or death events compared to TTS