Prognostic factors in neoadjuvant treatment followed by surgery in stage IIIA-N2 non-small cell lung cancer: a multi-institutional study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society)

Couñago, Felipe; Montemuiño, S.; Martín, M.; Taboada, B.; Calvo-Crespo, Patricia; Samper-Ots, M.P.; Alçântara, P.; Corona, J.; López-Guerra, José Luis; Murcia-Mejía, M.; López-Mata, M.; Jové, Josep; Chust, M.; Díaz-Díaz, V.; Ingunza-Barón, Lourdes de; García-Cañibano, T.; Couselo, M.L.; Cerro, Elia del; Moradiellos, Javier; Amor, Sergio; Varela, A.; Puertas, M M; Thuissard, Israel; Sanz-Rosa, David; Dios, N. Rodriguez De

doi:10.1007/s12094-018-1976-3

Cited by 11 publications

(12 citation statements)

References 18 publications

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“…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

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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.

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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

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“…PRSC risk groups showed an overall significant difference for OS (p < 0.001, Fig. 3E) [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25], and the high-risk group a median DFS of 9.5 months (95% CI 7-26). The overall difference in DFS was significant (p < 0.001, Fig.…”

Section: Prognostic Value Of the Prognostic Scorementioning

confidence: 99%

“…However, only a limited number of patients receiving neoadjuvant treatment were included [8][9][10]. To our knowledge, there are no models explicitly designed for NSCLC resected after neoadjuvant treatment, though different clinicopathological parameters have been shown to significantly impact survival [11][12][13]. The amount of residual tumor is one important parameter [3,14,15].…”

Section: Introductionmentioning

confidence: 99%

A prognostic score for non-small cell lung cancer resected after neoadjuvant therapy in comparison with the tumor-node-metastases classification and major pathological response

et al. 2021

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Studies validating the prognostic accuracy of the tumor-node-metastases (TNM) classification in patients with lung cancer treated by neoadjuvant therapy are scarce. Tumor regression, particularly major pathological response (MPR), is an acknowledged prognostic factor in this setting. We aimed to validate a novel combined prognostic score. This retrospective single-center study was conducted on 117 consecutive patients with non-small cell lung cancer resected after neoadjuvant treatment at a Swiss University Cancer Center between 2000 and 2016. All cases were clinicopathologically re-evaluated. We assessed the prognostic performance of a novel prognostic score (PRSC) combining T-category, lymph node status, and MPR, in comparison with the eighth edition of the TNM classification (TNM8), the size adapted TNM8 as proposed by the International Association for the Study of Lung Cancer (IASLC) and MPR alone. The isolated ypT-category and the combined TNM8 stages accurately differentiated overall survival (OS, stage p = 0.004) and disease-free survival (DFS, stage p = 0.018). Tumor regression had a prognostic impact. Optimal cut-offs for MPR emerged as 65% for adenocarcinoma and 10% for non-adenocarcinoma and were statistically significant for survival (OS p = 0.006, DFS p < 0.001). The PRSC differentiated between three prognostic groups (OS and DFS p < 0.001), and was superior compared to the stratification using MPR alone or the TNM8 systems, visualized by lower Akaike (AIC) and Bayesian information criterion (BIC) values. In the multivariate analyses, stage III tumors (HR 4.956, p = 0.003), tumors without MPR (HR 2.432, p = 0.015), and PRSC high-risk tumors (HR 5.692, p < 0.001) had significantly increased risks of occurring death. In conclusion, we support 65% as the optimal cut-off for MPR in adenocarcinomas. TNM8 and MPR were comparable regarding their prognostic significance. The novel prognostic score performed distinctly better regarding OS and DFS.

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“…Yamaguchi et al [17] found that there was no signi cant difference in 5-year survival between lobectomy and PN in patients with advanced tumors who received chemoradiotherapy before surgery and recommended that patients needing PN be treated with caution, and Brunelli et al [18] have observed that neoadjuvant chemotherapy is not associated with an increased perioperative risk in PN patients. Therefore, while the current clinical research indicates that both neoadjuvant and adjuvant chemotherapy can be recommended for patients undergoing PN [19], adjuvant radiotherapy remains controversial and may require further research.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Characteristics and Survival Outcomes for Pneumonectomy: a Population-Based Study

Wang

Liu

et al. 2020

Preprint

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Background: Prognostic factors in pneumonectomy (PN) are not yet fully defined. This study is to analyze and evaluate long-term survival after PN for non-small cell lung cancer (NSCLC). Methods: We obtained data from the Surveillance, Epidemiology, and End Results (SEER) database for patients who underwent PN between 2004 and 2015. In order to reduce bias and imbalance, propensity score matching (PSM) analysis was performed. We used Kaplan-Meier curves to estimate overall survival (OS), performed univariate and multivariate Cox proportional hazards regression analyses to identify independent prognostic factors for OS, and applied the Cox proportional hazards model to create a forest plot. Results: A total of 1557 PN patients from the SEER database were included. The patients were grouped according to the side of PN. Before matching, OS was worse after right PN (hazard ratio [HR]: 1.303; 95% confidence interval [CI] 1.133-1.498; P<0.001), but survival difference between groups was not significant after matching (HR: 1.061; 95% CI 0.912-1.235; P=0.443). Regression analysis revealed that age, grade, N-stage, radiotherapy, and chemotherapy were independent predictors of OS (P<0.05). Chemotherapy was associated with improved OS (HR: 0.709; 95% CI 0.609-0.825; P<0.001), but radiotherapy was associated with increased risk of death in OS (HR: 1.268; 95% CI 1.061-1.561; P=0.009). On the forest plot, patients with primary overlapping lesions had better OS (HR: 0.684; 95% CI 0.497-0.941; P=0.020) in left, vs right, PN; patients diagnosis during 2004 to 2007 had lower OS (HR: 0.576; 95% CI 0.346-0.960; P=0.034) for left PN vs right PN.Conclusions: Laterality was not a significant prognostic factor for long-term survival after PN for NSCLC. Chemotherapy was a significant independent predictor of improved OS, while radiotherapy appeared to be a negative prognostic factor with increased risk of death in OS.

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Prognostic factors in neoadjuvant treatment followed by surgery in stage IIIA-N2 non-small cell lung cancer: a multi-institutional study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society)

Cited by 11 publications

References 18 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

A prognostic score for non-small cell lung cancer resected after neoadjuvant therapy in comparison with the tumor-node-metastases classification and major pathological response

Clinicopathological Characteristics and Survival Outcomes for Pneumonectomy: a Population-Based Study

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