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C. Labbé



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    P3.01 - Advanced NSCLC (ID 621)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P3.01-080 - Overall Survival (OS) of Pathological N2 Non-Small Cell Lung Cancer (NSCLC) After Surgical Resection (ID 10316)

      09:30 - 09:30  |  Author(s): C. Labbé

      • Abstract

      Background:
      Despite complete pre-operative staging, incidental N2 disease is still found during surgical resection of NSCLC. Proceeding with resection versus aborting the operation to treat with definitive chemotherapy and radiotherapy is controversial. The aim of the current study was to evaluate survival of pathological N2 disease after complete resection.

      Method:
      The Institut de Cardiologie et Pneumologie de Quebec Biobank was queried for all patients with pathological N2 NSCLC who underwent complete (R0) surgical resection either by lobectomy, bilobectomy or pneumonectomy between January 2000 and February 2017. Survival was examined using the Kaplan-Meier method with log rank analysis. Significance was set at p≤0.05.

      Result:
      We identified 224 eligible patients; 119 (53%) were male, mean age was 63±9, there were 143 (64%) adenocarcinoma and 60 (27%) squamous cell carcinoma. Regarding surgical modality, 156 (70%) patients underwent lobectomy or bilobectomy and 68 (30%) pneumonectomy. The 30-day mortality of the cohort was 3% (5 pneumonectomy and 2 lobectomy). During 17 years of follow-up, 142 (63%) patients died, including 87 (61%) in the lobectomy/bilobectomy group and 55 (39%) in the pneumonectomy group. Among all deaths, 105 (74%) were cancer-related. Median OS of the entire cohort was 2.6 y (CI 1.9-4.4). In the univariate analysis cox model, median OS was shorter for pneumonectomy than lobectomy/bilobectomy (2,1 years [1,6-2,6) vs 4,4 years [2,2-5,8]), HR 1.54 (CI 1.09 – 2.16, p=0.01; figure 1). However, when only considering cancer-related deaths, the difference was not statistically significant (p=0.95). Figure 1: Overall survival of pathological N2 according to type of resection. Figure 1



      Conclusion:
      In our institutional database study, median OS after surgical resection of N2 NSCLC was 2.6y. Pneumonectomy is indicated as cancer cure treatment however, major efforts should be made to decrease peri-operative morbidity and mortality.