Author of

• 10720

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  P1.09 - Poster Session 1 - Combined Modality (ID 212)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Combined Modality
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10723

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    P1.09-003 - Prognostic impact of secondary pathologic findings on the outcome of patients with resected locally advanced non-small cell lung cancer previously treated with inductive chemotherapy or chemoradiation (ID 296)

    09:30 - 09:30  |  Author(s): T. Taberner-Bonastre
    • Abstract

    Background
    Half of non-small cell lung cancers are diagnosed in locally-advanced stages (LA-NSCLC), and warrant multidisciplinary treatments. Inductive and adjuvant therapies obtain the same survival benefit after surgery, but the first ones also provide prognostic information. Mediastinal downstaging and pathologic complete response preclude a better outcome. However, the value of minor pathologic features has been scarcely analyzed. We report the impact of lymphovascular invasion (LVI) and tumor necrosis (TN) on the prognosis of resected LA-NSCLC after inductive chemotherapy (iCT) or chemoradiation (iCRT).

    Methods
    We retrospectively reviewed 50 resected LA-NSCLC treated with iCT or iCRT in our center from October-2004 to June-2012. Three patients died due to early surgery complications and were not analyzed. The impact of ILV, TN, pneumonitis, extracapsular (EI) and pleural invasion (PI) on disease free (DFS) and overall survival (OS) was analyzed in the remaining patients

    Results
    Our series included 42 men and 5 women aged between 47-82 years. Non-specified NSCLC was diagnosed in nine, adenocarcinoma in two, and squamous carcinoma in 36. Thirty-seven received cisplatin-based and 10 carboplatin-based chemotherapy. Concurrent radiation was administered in 21. Pneumonectomy was performed in 15, lobectomy in 26, and segmentectomy in 6. The presence of pneumonitis, EI, or PI in the resected specimens did not impact on the outcome of the patients. However, DFS and OS clearly worsened when LVI (34.1 vs. 14.1 months, p= 0.01; and 43 vs. 29, p= 0.005; respectively), and absence of TN (31.6 vs. 24.3, p= 0.045; and 42 vs. 33, p= 0.041, respectively) were found. Radiation, cis- or carboplatin administration, and treatment length did not modify LVI and TN incidence

    Conclusion
    Minor pathologic features as LVI and TN significantly impact on the prognosis of resected LA-NSCLC after iCT or iCRT. Implications of that should be further analyzed. Figure 1. DFS and OS Kaplan-Meier curves according to the presence of LVI. Figure 1