Author of

• 15343

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  P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)

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

  • 15356

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    P3.03-013 - Predictive Factors for Survival in Stage IIIA (N2) NSCLC Patients Treated with Neoadjuvant Chemotherapy Followed by Surgery (ID 2770)

    09:30 - 09:30  |  Author(s): W. Mao
    • Abstract

    Background:
    For locally advanced non-small cell lung cancer (NSCLC) patients, although the evidence level for induction chemo (chemoradio) therapy is low, the incorporation of chemotherapy, radiotherapy, and surgery will greatly impact the strategy of future treatment. The objective of this study was to evaluate the risks of recurrence and overall survival (OS) in stage IIIA (N2) NSCLC patients undergoing definitive resection after neoadjuvant chemotherapy.
    
    Methods:
    A retrospective analysis of 106 consecutive patients with stage IIIA (N2) NSCLC who received neoadjuvant chemotherapy followed by surgery between January 2008 and October 2013. While reviewing the clinical and surgical data, we also assessed histopathologic and imaging (chest CT scan) factors. Disease-free survival (DFS) and OS were estimated with predictors for recurrence and survival. The Kaplan–Meier method was used to evaluate patient DFS and OS. Univariate analysis of patient clinical characteristics and treatment response were conducted using the Chi-square and Fisher’s exact test.
    
    Results:
    Median age was 60, 96 (90.5%) patients were male, 85 (80.2%) patients were squamous cell carcinoma and 21 (19.8%) patients were non-squamous cell carcinoma, 93 (87.7%) patients had a lobectomy. The 3-year OS for patients with and without recurrence was 33.1 and 56.7 %, respectively (p < 0.001). Size decrease of target lesion(s) ≥30 % on post-neoadjuvant chemotherapy chest CT scan (p = 0.040), primary tumor size on surgical specimen <10 mm (p = 0.047), and pathological complete remission in the mediastinal lymph nodes were related to longer OS. Larger tumor size on post-neoadjuvant chemotherapy chest CT scan (p = 0.038), male gender (p = 0.043), squamous cell carcinoma (p = 0.048), larger primary tumor size on surgical specimen (p = 0.041), pathological non-complete remission in the mediastinal lymph nodes (p = 0.031 ) were related to shorter DFS significantly.
    
    Conclusion:
    OS is prolonged with greater extent of size decrease of target lesion(s) on post-neoadjuvant chemotherapy chest CT scan, smaller tumor size on surgical specimen and pathological complete remission in the mediastinal lymph nodes. Larger tumor size on post-neoadjuvant chemotherapy chest CT scan, male gender, squamous cell carcinoma, larger primary tumor size on surgical specimen, pathological non-complete remission in the mediastinal lymph nodes may prone to the higher probability of recurrence.