Filippo Lococo1,2, Marco Chiappetta2, Carolina Sassorossi2, Dania Nachira1,2, Jessica Evangelista2, Leonardo Petracca Ciavarella2, Maria Teresa Congedo2, Venanzio Porziella1,2, Luca Boldrini1,3, Annarita Larici1,4, Emilio Bria1,5, Stefano Margaritora1,2.
Abstract
AIMS: To explore the long-term survivals in lung cancer patients with persistent mediastinal lymph nodal disease after neoadjuvant followed by surgical resection and to analyse prognostic factor in this specific susbset of patients Background: Surgery in non-small-cell lung cancer (NSCLC) patients with N2-disease after neoadjuvant therapy (NAD) has been debated and, with the advent of immunotherapy, has been even more questioned.
OBJECTIVE: Describe long-term results of multimodal approach in locally-advanced NSCLC patients with persistence of N2-disease and identify prognostic factors to target the strategy of care Method: We retrospectively reviewed data of 121 consecutive Stage IIIA-N2 NSCLC patients who underwent NAD (chemoradiotherapy or chemotherapy) from 01/00 to 12/19, focusing our analysis on 37 patients with persistent N2s status after surgery. The associations between mortality and potential risk factors were explored with Kaplan-Meier and Cox regression analysis. RESULT: The 5-year survival was 29.8%. Cox regression analysis suggested that young age (HR=0.98, C.I.95%: 0.97- 1.00; p=0.062), male sex (HR=3.8,C.I.95%:1.06-13.73;p=0.04), and adjuvant therapy (HR=6.81,C.I.95%:0.96-53.94;p=0.06) influenced long-term outcomes in these patients.
CONCLUSION: We herein observed suboptimal long-term results in this NSCLC patient subset and, considering emerging results adopting immunotherapy following chemoradiotherapy, surgery should be carefully considered in very selected cases (young and clinically fit patients) and combined with adjuvant therapy after surgery. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.
AIMS: To explore the long-term survivals in lung cancer patients with persistent mediastinal lymph nodal disease after neoadjuvant followed by surgical resection and to analyse prognostic factor in this specific susbset of patients Background: Surgery in non-small-cell lung cancer (NSCLC) patients with N2-disease after neoadjuvant therapy (NAD) has been debated and, with the advent of immunotherapy, has been even more questioned.
OBJECTIVE: Describe long-term results of multimodal approach in locally-advanced NSCLC patients with persistence of N2-disease and identify prognostic factors to target the strategy of care Method: We retrospectively reviewed data of 121 consecutive Stage IIIA-N2 NSCLC patients who underwent NAD (chemoradiotherapy or chemotherapy) from 01/00 to 12/19, focusing our analysis on 37 patients with persistent N2s status after surgery. The associations between mortality and potential risk factors were explored with Kaplan-Meier and Cox regression analysis. RESULT: The 5-year survival was 29.8%. Cox regression analysis suggested that young age (HR=0.98, C.I.95%: 0.97- 1.00; p=0.062), male sex (HR=3.8,C.I.95%:1.06-13.73;p=0.04), and adjuvant therapy (HR=6.81,C.I.95%:0.96-53.94;p=0.06) influenced long-term outcomes in these patients.
CONCLUSION: We herein observed suboptimal long-term results in this NSCLC patient subset and, considering emerging results adopting immunotherapy following chemoradiotherapy, surgery should be carefully considered in very selected cases (young and clinically fit patients) and combined with adjuvant therapy after surgery. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.
Entities:
Keywords:
chemotherapy; lung cancer; lymph nodes; neoadjuvant therapy; radiotherapy; surgery
Year: 2022
PMID： 35593341 DOI： 10.2174/1574887117666220518102321
Source DB: PubMed Journal: Rev Recent Clin Trials ISSN： 1574-8871