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  P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Treatment of Localized Disease - NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15313

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    P3.02-012 - Post-Surgical Recurrence of cN0-1 and pN2 Non-Small-Cell Lung Cancer in Postoperative Radiotherapy Candidates (ID 618)

    09:30 - 09:30  |  Author(s): H. Yamamoto
    • Abstract
    • Slides

    Background:
    Radiotherapy after initial surgery significantly improves outcomes in patients with pathological N2 non-small–cell lung cancer (NSCLC). Here, we aimed to identify best candidates for postoperative radiotherapy among patients with local recurrence.
    
    Methods:
    Among patients who underwent complete resections for NSCLC between August 2007 and December 2011 in our hospital, we enrolled all 21 patients with clinical N0–1 and pathological N2 NSCLC in this study. We assessed their age, sex, tumor size, histology, differentiation, lymphatic permeation, vessel invasion, pathological N2 location, pathological N2 number, and adjuvant chemotherapy, and classified them as the local recurrence group (recurrences limited to lymph nodes up to N3 or adjacent to the surgical margin), the distant recurrence group (in whom distant recurrence occurred within 6 months after local recurrence) and the no-recurrence group. Relationships between these clinical parameters and recurrence patterns (local or distant) were statistically assessed by Fisher’s exact test.
    
    Results:
    All 21 patients underwent lobectomies and systematic mediastinal nodal dissections that included upper mediastinal nodes and subcarinal nodes. Postoperatively, 17 patients underwent chemotherapy and none underwent radiotherapy. Recurrence was seen in 15 patients: 5 local and 10 distant recurrences. Histologically, squamous cell carcinomas (SCC) were significantly more common in the local recurrence group (P=0.0358) at 3 SCC and 2 adenocarcinomas (AD), compared with the distant recurrence group: 0 SCC and 10 AD; and the no-recurrence group: 2 SCC and 4 AD. No other clinical factors were significantly associated with recurrence. Notably, vessel invasion was seen in 80% of the local recurrence group, 90% of the distant recurrence group, and 17% of the no-recurrence group.
    
    Conclusion:
    Among patients with clinical N0 or N1 and pathological N2 NSCLC, postoperative radiotherapy was most suited to those whose pathology showed SCC.
    
    

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