Author of

• 11673

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  P2.09 - Poster Session 2 - Combined Modality (ID 213)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Combined Modality
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11675

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    P2.09-002 - Prognostic impact of conventional and modified measurement of mediastinal lymph node involvement in the outcome of patients with resected locally advanced non-small cell lung cancers previously treated with inductive chemo or chemoradiation (ID 299)

    09:30 - 09:30  |  Author(s): J.M. Duran Alhama
    • Abstract

    Background
    Mediastinal lymph node involvement (MLNI) is the strongest prognostic factor of resected locally advanced non-small cell lung cancers (LA-NSCLC). The 7[th] edition of the TNM is based in purely topographic criteria: N2 is applied for ipsilateral MLNI and N3 for contralateral and unresectable MLNI. Different authors have proposed many other prognostic classifications of MLNI

    Methods
    We retrospectively reviewed 45 resected LA-NSCLC previously treated with inductive chemo or chemoradiation in our center between October-2004 to June-2012. Three patients died due to early surgical complication were not analyzed. Systematic mediastinal dissection was performed in all of them. The prognostic impact of pN2 was statistically compared to number of resected nodes; number of affected areas; number of metastatic nodes; and ratio of metastatic/resected nodes

    Results
    Our series included 37 men and 5 women with a mean age of 64.64 years-old. There were diagnosed eight non-specified NSCLC, two adenocarcinomas, and 32 squamous carcinomas. Cis- and carboplatin-based chemotherapy was administered in 35 and seven patients, respectively. Concurrent radiation was administered in 21. pN2 MLNI clearly worsened both disease free (DSF) and overall survival (OS) of the patients (p= 0.006; and p= 0.018, respectively). Proportion of patients with pN2 MLNI was lower when radiation was applied (p= 0.033) and did not significantly vary according to chemotherapeutic regimen or histology. The number of resected nodes did not impact on survival (DFS p= 0.261, and OS p= 0.277), but OS was better in patients with a lower rate of pathologically detected nodes (p= 0.046). The number of metastatic nodes according to the Tokio score did not impact on survival. The Regina Elena and the Mount Sinai ratios of metastatic nodes according to the number of resected nodes neither impacted

    Conclusion
    The presence of pN2 MLNI according to the 7[th] edition of the TNM classification is the strongest mediastinal prognostic factor in our series of resected LA-NSCLC previously treated with inductive chemo or chemoradiation. No other tested classification of MLNI could predict significant differences in survival. The prognostic significance of the lower detection rate of resected nodes after inductive treatment should be explored. Figure 1. DFS and OS Kaplan-Meier curves according to MLNI. Figure 1