P-243 Outcome and prognostic factors in surgical combined modality treatment of 131 stage IIIA-N2 non-small cell lung cancer (NSCLC) patients

Lorent, Natalie; Vansteenkiste, Johan; Leyn, Paul De; Lievens, Yolande; Nackaerts, Kristiaan; Dooms, Christophe; Anrys, Beatrijs; Demedts, Maurits

doi:10.1016/s0169-5002(03)92212-4

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“…The mortality rate in our study was 5% (n ¼ 6), which was higher than the literature. [6][7][8] It was determined that our mortality rate was high especially in the early period of our series, and this rate decreased over time. The most important factor in mortality was pneumonia (n ¼ 3).…”

Section: Discussionmentioning

confidence: 81%

“…A possible approach to patients with resectable stage IIIA-N2 NSCLC is resection following the neoadjuvant thera-py. 7,8,14,15 In the intergroup lung study, 16 Studies over the years have shown that adding radiotherapy to chemotherapy does not improve survival compared with chemotherapy alone, even if pathological complete response (pCR) rates are higher. 18,19 In our study, the frequency of CRT application decreased over the years, and the rate of neoadjuvant chemotherapy only increased.…”

Section: Discussionmentioning

confidence: 99%

“…Mediastinal lymph nodes may be radiologically normal or enlarged. After neoadjuvant therapy, surgery is possible with acceptable mortality and morbidity, [6][7][8] and it provides a better 5YS rate compared with resection alone. Focusing on the details of the results of this particular group, 5YS after postneoadjuvant surgical resection has been reported as 40% in patients with pN0 disease, 9 and even 65% in patients with pathological complete response ypT0N0.…”

Section: Introductionmentioning

confidence: 99%

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Survival Analysis of Surgically Resected ypN2 Lung Cancer after Neoadjuvant Therapy

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2022

Thorac Cardiovasc Surg

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Introduction Surgery is widely accepted today when downstaging of mediastinal lymph nodes after neoadjuvant therapy is achieved. However, the role of surgery in patients with persistent N2 disease is still controversial. This study aims to detail the diagnostic problems, prognostic features, and long-term survival of the persistent N2 non-small cell lung cancer patient group. Patients and Methods One-hundred fifty patients who received neoadjuvant therapy and subsequently underwent resection, in-between 2003 and 2015, were retrospectively analyzed. In this study, “persistent N2” group refers to patients who received neoadjuvant therapy for clinically or histologically proven N2, who underwent a surgery after having been classified as “downstaged” at restaging, but in whom ypN2 lesions were subsequently confirmed on the operative specimens. Patients with multistation N2 were included in the study. There were 119 patients who met the criteria, whereas persistent ypN2 was detected in 28.5% (n = 34) of all patients. Results Overall 5-year survival rate was 47.2%, while it was 23.4% for patients with persistent N2. Factors that adversely affected survival were to have nonsquamous cell histological type (p = 0.006), high ypT stage (p = 0.001), persistent N2 (p = 0.02), and recurrence during follow-up (p < 0.001). A trend toward a shorter survival was observed when the ypN2 zone was subcarinal versus other zones, but did not reach statistical significance (p = 0.08). In addition, a trend toward a shorter survival of patients with multiple N2 involvement (p = 0.412) was observed. Conclusion In the persistent N2 group, when multiple involvement or subcarinal involvement was excluded, relatively good survival was detected.

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Section: Discussionmentioning

confidence: 81%