Author of

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  P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Treatment of Locoregional Disease – NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 14456

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    P2.03-005 - Surgical Resection after Definitive Chemoradiotherapy (ID 782)

    09:30 - 09:30  |  Author(s): J.A. Maestre
    • Abstract
    • Slides

    Background:
    Approximately, 30% of non-small-cell lung cancer (NSCLC) patients are diagnosed with locally advanced disease (IIIA-B). Treatment of these patients is controversial, with recommendations including definitive chemoradiotherapy, induction chemotherapy followed by surgery or induction chemoradiotherapy followed by surgical resection. Salvage surgery is defined as resection after high doses of radiation (>50Gy), planned as a primary curative intent, and usually more than 12 weeks after radiotherapy. Lung resection after high-dose radiotherapy has traditionally been avoided due to high rates of morbidity and mortality.
    
    Methods:
    The aim of this review is to analyze the outcome of patients referred to our institution for surgical resection after definitive chemoradiation. We reviewed 23 NSCLC patients who underwent surgical treatment after definitive chemoradiation between 2003 and 2014.
    
    Results:
    There were 15 men and eight women with a median age of 54.64 years (range 33-69 years). Fifteen patients were diagnosed with adenocarcinoma (65.2%), and the most frequent cTNM stage was T3N2M0 (34.8%) followed by T2N2M0 and T4N2M0. The type of surgical resection included five lobectomies, six bilobectomies and 12 pneumonectomies (seven right and five left pneumonectomies). Four patients showed a complete pathological response after treatment (pT0N0M0 17.4%). There was only one postoperative death due to a bronchopleural fistula. All patients received platinum-based chemotherapy and definitive radiotherapy, with a median dose of 65Gy (range 45-70Gy). Median time from radiotherapy to surgical resection was 8.28 months (0.9-35.47 months). Six patients suffered recurrence after surgery, three to a distant site and three local recurrences. Median disease free survival for the group of patients who relapsed after surgery was 7.7 months (3.9-17.5 months). Figure 1 Median overall survival was 88.3 months (CI 95% 57.6–118.9), with 1, 3 and 5 year survival rates of 87%, 74.5% and 66.3% respectively. Figure 2
    
    
    
    
    
    Conclusion:
    Salvage surgery after definitive chemoradiotherapy is feasible, with low postoperative complication rates and encouraging survival.
    
    

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