Pathologic complete response after induction therapy—the role of surgery in stage IIIA/B locally advanced non-small cell lung cancer

Schreiner, W; Gavrychenkova, S.; Dudek, Wojciech; Rieker, Ralf J.; Lettmaier, Sebastian; Fietkau, Rainer; Sı̂rbu, Horia

doi:10.21037/jtd.2018.05.68

Cited by 13 publications

(9 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previously, a large of studies including prospective and retrospective analyses focused on the treatment for NSCLC [8][9][10][11][12][13][14][15] , because NSCLC accounted for 85% of lung cancer cases 16 . It has been reported that surgery combined with chemotherapy/ radiotherapy may improve the survival of the patients with advanced NSCLC 9,15 .…”

Section: Discussionmentioning

confidence: 99%

Benefits of surgery in the multimodality treatment of stage IIB-IIIC small cell lung cancer

Yang¹,

Yuan²,

Zhan³

et al. 2019

J. Cancer

View full text Add to dashboard Cite

Surgery combined with chemotherapy/radiotherapy is recommended for early stage small cell lung cancer (SCLC); however, the role of surgery in the multimodality treatment of advanced disease remains controversial. The clinical data of patients between 2000 and 2015 were obtained from the Surveillance, Epidemiology, and End Results database. The surgery group included 998 patients with stage IIB-IIIC. A matched non-surgery group (n = 2994) was generated by propensity score matching. The Kaplan-Meier method and log-rank tests were used for survival analyses. Univariate and multivariate analyses were used to identify significant prognostic factors. After matching, there were no significant differences between the two groups in race, age, sex, T classification, N classification, TNM stage, marital status, primary sites, and origin record NAACCR Hispanic Identification Algorithm (NHIA). The surgery group showed better overall survival and cancer-specific survival than the non-surgery group. Univariate and multivariate analyses showed that therapy methods, age, sex, T classification, and N classification were independent prognostic predictors for stage IIB-IIIC SCLC (all P < 0.05). Stratified analyses showed that survival outcomes favored surgery in any age groups, men and women, any T classification except T3, and N0-2 but not N3 compared with non-surgical treatment. The survival differences favored surgery in stage IIB and IIIA SCLC, although they were not significant in stage IIB and IIIC SCLC. Therefore, surgery was associated with improved survival in stage IIB and IIIA SCLC, but not in stage IIIB and IIIC SCLC.

show abstract

Section: Discussionmentioning

confidence: 99%

Benefits of surgery in the multimodality treatment of stage IIB-IIIC small cell lung cancer

Yang¹,

Yuan²,

Zhan³

et al. 2019

J. Cancer

View full text Add to dashboard Cite

show abstract

“…4,15 On the one hand, the tumor resection for pathologic examination seems reasonable, as long as the tumor appears resectable, to identify the best effective IT protocol and, subsequently to extend the treatment modality to a larger patient number in terms of better outcome. 4,16 The pCR was recently identified as a dominant prognostic factor for LTS and PFS, superior to mediastinal downstaging, female gender, and patient age. 17 On the other hand, even accepting the fact that the pCR after IT is the main prognostic determinant in locally advanced NSCLC patients, the clinical implication into daily clinical practice is difficult due to the wide incidence variability after IT, inconsistent presentation, and inaccurate clinical-radiological preoperative estimation.…”

Section: Discussionmentioning

confidence: 99%

Major Pathologic Response after Induction Therapy Has a Long-Term Impact on Survival and Tumor Recurrence in Stage IIIA/B Locally Advanced NSCLC

Schreiner

Dudek

Rieker

et al. 2019

Thorac Cardiovasc Surg

Self Cite

View full text Add to dashboard Cite

Background Major pathologic response (MPR) determines favorable outcome in locally advanced non-small cell lung cancer after induction therapy (IT) followed by lung resection. The aim of this retrospective study was to identify the prognostic relevance of MPR in long-term interval. Methods In 55 patients, the survival rate according to MPR and non-MPR was estimated by Kaplan–Meier method and compared using log-rank, Breslow, and Tarone–Ware tests. Results The IT included chemoradiation with 50.4 Gy (range: 45–56.4 Gy) combined with platinum-based chemotherapy in 52 patients (94.5%) and platinum-based chemotherapy in 3 patients (5.5%). Perioperative morbidity and 30-day mortality were 36 and 3.6%, respectively. The estimated 5-year postoperative and progressive-free survivals were statistically significantly improved in MPR versus non-MPR with 53.5 versus 18% and 49.4 versus 18.5%, respectively. According to the log-rank, Breslow, and Tarone–Ware tests, the MPR demonstrates prognostic significance in early, long-term, and whole postoperative interval. Conclusion MPR is associated with a robust correlation to long-term postoperative and recurrence-free survival improvement, and can potentially simplify the multidisciplinary debate and allow further stratification of adjuvant treatment in multimodality therapy.

show abstract

“…Unlike the case with NSCLC, surgery-plus-chemotherapy treatment is recommended for stage I SCLC patients, and can be used to guide the management of LS-SCLC patients. Given the greater proportion (85%) of NSCLC in all lung cancer cases (8), the treatment of NSCLC has been focused in most previous prospective and retrospective studies (9)(10)(11)(12). Generally, it is recommended that adjuvant chemotherapy following resection for patients with stage II and IIIA NSCLC is required, but not for stage I patients (6).…”

Section: Discussionmentioning

confidence: 99%

Surgery Plus Chemotherapy Versus Surgery Alone for Limited-Stage Small-Cell Lung Cancer: A Population-Based Survival Outcome Analysis

Guo

Zhang

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

IntroductionFor patients with limited-stage small-cell lung cancer (LS-SCLC), effective treatment methods still remain a clinical challenge. The aim of this study is to evaluate the survival outcome of surgery plus chemotherapy vs. surgery alone in patients with LS-SCLC.MethodsLS-SCLC patients selected from the Surveillance, Epidemiology and End Results (SEER) database diagnosed between January 1, 2004, and December 31, 2015. Comparison of overall survival (OS) and cancer-specific survival (CSS) between two groups performed propensity score matching (PSM), inverse probability of treatment weight (IPTW), and overlap weighting analysis.ResultsOf the 477 LS-SCLC patients identified from the SEER database between 2004 and 2015, 262 (54.9%) received surgery-plus-chemotherapy treatment and the others received surgery-alone treatment. Univariate and multivariate analyses showed that treatment option (P< 0.001), tumor location (P= 0.02) and AJCC stage (P< 0.001) were independent prognostic predictors of OS in LS-SCLC patients. Median OS was 35 months in surgery-plus-chemotherapy group vs. 23 months in surgery-alone group. Survival analysis showed that surgery plus chemotherapy offered significantly improved OS as compared with surgery-alone treatment before and after IPTW, PSM and overlap weighting method (all P< 0.05). According to AJCC stage stratification, OS of the unmatched patients with stage I (P= 0.049) and II (P= 0.001) SCLC who received surgery-plus-chemotherapy treatment was significantly better than that of surgery-alone patients.ConclusionsThis cohort study showed that surgery plus chemotherapy was associated with longer survival time than surgery alone in LS-SCLC patients, especially in those with stage I and II SCLC. Further prospective studies are required to confirm our conclusions.

show abstract

Pathologic complete response after induction therapy—the role of surgery in stage IIIA/B locally advanced non-small cell lung cancer

Cited by 13 publications

References 37 publications

Benefits of surgery in the multimodality treatment of stage IIB-IIIC small cell lung cancer

Benefits of surgery in the multimodality treatment of stage IIB-IIIC small cell lung cancer

Major Pathologic Response after Induction Therapy Has a Long-Term Impact on Survival and Tumor Recurrence in Stage IIIA/B Locally Advanced NSCLC

Surgery Plus Chemotherapy Versus Surgery Alone for Limited-Stage Small-Cell Lung Cancer: A Population-Based Survival Outcome Analysis

Contact Info

Product

Resources

About