Predictive factors and prognosis of microscopic residual disease in non-small-cell lung cancer surgery

Abstract

OBJECTIVES We described patients with microscopic residual disease (R1) operated on for non-small-cell lung cancer (NSCLC) and investigated predictive factors for R1. We also examined prognostic factors for overall survival in these patients. METHODS From June 2003 to December 2019, a total of 2595 patients benefited from an anatomical resection operation for NSCLC in our department. All preoperative data were prospectively collected in Epithor, the French thoracic surgery national database. All pre-, per- and postoperative care followed the current recommendations. Tumours were classified by experienced pathologists according to the TNM classification and the resection status R. Survival information was collected retrospectively using the French national death register. RESULTS A total of 94 R1 patients (3.6%) and 2255 R0 patients (86.9%) were identified. R1 patients showed significant differences: They were older (p = 0.02), with a high rate of pneumonectomy(p < 0.001), more squamous cell carcinomas (p < 0.001) and more cases of advanced-stage disease (p < 0.001). We proved that incomplete resection was a poor and independent prognostic factor whereas complete resection had a significant impact on overall survival (HR: 4.66 [3.46–6.27]). Thus, we identified high clinical T status (odds ratio [OR]: 8.82 [5.00–15.56]), high clinical N status (OR: 3.54 [2.13–5.87), squamous cell carcinoma (OR: 3.86 [2.33–6.42]), obesity (OR 1.91 [1.04–3.52]) and low forced expiratory volume in 1 s (OR: 3.62 [1.70–7.68]) as risk factors for R1. No statistical differences were found according to the location of positive resection margin or treatment, whether adjuvant or neoadjuvant. CONCLUSIONS Incomplete resection was a poor prognostic factor for overall survival of patients operated on for NSCLC, particularly in the advanced stages of the disease. Identification of different predictive factors should help to avoid this situation. subj collection: 152

Body mass index, weight change, and cancer prognosis: a meta-analysis and systematic review of 73 cohort studies

“…Papers with HR data for OS were retained for BMI-related data ( n = 52). 24 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 For weight change-related data, both HR data for OS and mortality data with events and total number of people in the exposed and non-exposed groups as initial data were retained ( n = 27). 24 , 26 , 41 , 48 , 51 , 76 , 86 , 87 , 88 , 89 , 90 , 91 , 92...…”

“…The results of the obese versus nonobese analysis are shown in Figure 2 . In this analysis, we included 22 studies, 24 , 37 , 42 , 43 , 44 , 46 , 47 , 50 , 53 , 55 , 56 , 59 , 66 , 67 , 71 , 72 , 74 , 77 , 80 , 81 , 84 with a total I 2 of 83% and an HR of 0.96 (95% CI 0.81-1.13; P = 0.59). Eight studies were included in the analysis of reproductive system cancers, including breast cancer ( n = 7) and endometrial cancer ( n = 1), and the results were not statistically significant.…”

Exosomes derived from M1 macrophages inhibit the proliferation of the A549 and H1299 lung cancer cell lines via the miRNA-let-7b-5p-GNG5 axis

“…In terms of the incidence of malignant tumors, lung cancer ranks first nationwide, with up to 780,000 cases diagnosed per year ( Cao & Chen, 2019 ). The incidence of lung cancer in men and women ranks first and second among all cancers, respectively, and lung cancer carries the highest mortality rate ( Rabinel et al, 2022 ; Tirilomi et al, 2022 ). Among the types of lung cancer, non-small-cell lung cancer (NSCLC) is most common, with an incidence rate of up to 85%.…”