Major Pathologic Response after Induction Therapy Has a Long-Term Impact on Survival and Tumor Recurrence in Stage IIIA/B Locally Advanced NSCLC.
Autor: Schreiner, Waldemar; Dudek, Wojciech; Rieker, Ralf Joachim; Lettmaier, Sebastian; Fietkau, Rainer; Sirbu, Horia
Publication year: 2020
The Thoracic and cardiovascular surgeon
issn:1439-1902 0171-6425
doi: 10.1055/s-0039-1679884
Abstract:
BACKGROUND: Major pathologic response (MPR) determines favorable outcome in locally advanced non-small cell lung cancer after induction therapy (IT) followed by lung resection. The aim of this retrospective study was to identify the prognostic relevance of MPR in long-term interval. METHODS: In 55 patients, the survival rate according to MPR and non-MPR was estimated by Kaplan-Meier method and compared using log-rank, Breslow, and Tarone-Ware tests. RESULTS: The IT included chemoradiation with 50.4 Gy (range: 45-56.4 Gy) combined with platinum-based chemotherapy in 52 patients (94.5%) and platinum-based chemotherapy in 3 patients (5.5%). Perioperative morbidity and 30-day mortality were 36 and 3.6%, respectively. The estimated 5-year postoperative and progressive-free survivals were statistically significantly improved in MPR versus non-MPR with 53.5 versus 18% and 49.4 versus 18.5%, respectively. According to the log-rank, Breslow, and Tarone-Ware tests, the MPR demonstrates prognostic significance in early, long-term, and whole postoperative interval. CONCLUSION: MPR is associated with a robust correlation to long-term postoperative and recurrence-free survival improvement, and can potentially simplify the multidisciplinary debate and allow further stratification of adjuvant treatment in multimodality therapy.
Language: eng
Rights: Thieme. All rights reserved.
Pmid: 30808023
Tags: Humans; Aged; Female; Male; Middle Aged; Retrospective Studies; Time Factors; Risk Factors; Neoplasm Staging; Progression-Free Survival; *Neoplasm Recurrence, Local; *Chemoradiotherapy, Adjuvant/adverse effects/mortality; *Induction Chemotherapy/adverse effects/mortality; *Neoadjuvant Therapy/adverse effects/mortality; *Pneumonectomy/adverse effects/mortality; Carcinoma, Non-Small-Cell Lung/mortality/pathology/*therapy; Lung Neoplasms/mortality/pathology/*therapy
Link: https://pubmed.ncbi.nlm.nih.gov/30808023/
