Recurrence and Risk Factors for Relapse in Patients with Non-Small Cell Lung Cancer Treated by Surgery with Curative Intent

Cruz, Cristiana; Afonso, Margarida; Oliveiros, Bárbara; Pêgo, Alice

doi:10.1159/000458533

Cited by 16 publications

(10 citation statements)

References 19 publications

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“…Surgery plays a key-role in the treatment. More than one-third of patients experience a relapse of disease, even after radical tumor resection in combination with systematic mediastinal and hilar lymph node dissection [ 2 ]. Nodal metastases have been repetitively identified as a strong predictive factor for survival.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Impact of PD-L1 Expression in pN1 NSCLC: A Retrospective Single-Center Analysis

Eichhorn

Kriegsmann

Klotz

et al. 2021

Cancers

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The programmed death-ligand 1 (PD-L1) plays a crucial role in immunomodulatory treatment concepts for end-stage non-small cell lung cancer (NSCLC). To date, its prognostic significance in patients with curative surgical treatment but regional nodal metastases, reflecting tumor spread beyond the primary site, is unclear. We evaluated the prognostic impact of PD-L1 expression in a surgical cohort of 277 consecutive patients with pN1 NSCLC on a tissue microarray. Patients with PD-L1 staining (clone SP263) on >1% of tumor cells were defined as PD-L1 positive. Tumor-specific survival (TSS) of the entire cohort was 64% at five years. Low tumor stage (p < 0.0001) and adjuvant therapy (p = 0.036) were identified as independent positive prognostic factors in multivariate analysis for TSS. PD-L1 negative patients had a significantly better survival following adjuvant chemotherapy than PD-L1 positive patients. The benefit of adjuvant therapy diminished in patients with PD-L1 expression in more than 10% of tumor cells. Stratification towards histologic subtype identified PD-L1 as a significant positive predictive factor for TSS after adjuvant therapy in patients with adenocarcinoma, but not squamous cell carcinoma. Routine PD-L1 assessment in curative intent treatment may help to identify patients with a better prognosis. Further research is needed to elucidate the predictive value of PD-L1 in an adjuvant setting.

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Section: Introductionmentioning

confidence: 99%

Prognostic Impact of PD-L1 Expression in pN1 NSCLC: A Retrospective Single-Center Analysis

Eichhorn

Kriegsmann

Klotz

et al. 2021

Cancers

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“…Non-small cell lung cancer (NSCLC) diagnosed at an early stage might be subjected to curatively intended lung cancer surgery. However, cancer recurrence occurs in 30-70% of operated NSCLC patients, with stage as an important prognostic factor [1,2]. Adjuvant chemotherapy has been shown to give an absolute increase in 5-year-survival by 4% in NSCLC [3].…”

Section: Introductionmentioning

confidence: 99%

Pre-operative plasma cell-free circulating tumor DNA and serum protein tumor markers as predictors of lung adenocarcinoma recurrence

et al. 2019

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Background: Lung cancer patients have a risk of recurrence even after curatively intended surgery. Cell-free circulating tumor DNA (ctDNA) and circulating tumor marker measurements are easily accessible through peripheral blood and could potentially identify patients with worse prognosis. The aim of this study was to examine ctDNA in pre-operative plasma and the role of tumor markers in pre-operative serum for their predictive potential on risk of tumor recurrence. Methods: Mutation analysis by 26-gene targeted sequencing was performed on 157 lung adenocarcinomas (ACs) from patients surgically treated at the Lund University Hospital 2005-2014. Of these, 58 tumors from patients in stages I-IIIA (34 stage I, 14 stage II and 10 stage III) with mutation(s) in EGFR, BRAF or KRAS were included. ctDNA from corresponding plasma (median 1.5 ml, range 1-1.6) was analyzed for one tumor-specific mutation in either of these three oncogenes using ultrasensitive IBSAFE droplet digital PCR (ddPCR). The tumor markers cancer antigen 125 (CA 125) and carbohydrate antigen 19-9 (CA 19-9) were analyzed in corresponding serum with electrochemiluminiscence immunoassay. Results: 6/7 patients with ctDNA and 19/51 without detected ctDNA were diagnosed with recurrence (log-rank test p ¼ .001). 8/10 patients with positive serum tumor markers and 17/47 without tumor markers were diagnosed with recurrence (log-rank test, p ¼ .0002). Fifteen patients had positive ctDNA and/or tumor markers, 12 of these had recurrence (log-rank test, p < .0001). Conclusion: A combination of tumor markers and ctDNA single mutation detection in low-volume pre-operative blood samples is a promising prognostic test. Prediction of recurrent disease in surgically treated early stage lung cancer can likely be further improved by using larger volumes of blood.

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“…Tumor recurrence is the most common cause of treatment failure after surgery despite the fact that surgery is widely accepted as a curative treatment for stage I, II, and IIIA NSCLC ( 19 ). In the present study, we determined the association between surgery and NSCLC recurrence.…”

Section: Discussionmentioning

confidence: 99%

Surgery and subsequent risk of non-small cell lung cancer recurrence: a meta-analysis of observational studies

Hu¹,

Miao²,

Li³

et al. 2020

Transl Cancer Res TCR

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Background: Surgery is the main treatment for stage I, II, and IIIA non-small cell lung cancer (NSCLC).However, the relationship between surgery and NSCLC recurrence is unclear. Thus, we performed a metaanalysis to determine whether surgery is associated with an increased risk of NSCLC recurrence.Methods: We used the electronic databases in PubMed, Web of Science, EMBASE, Cochrane Library and MEDLINE to carry out a systematic literature search before December 1st, 2017. All studies on the association between surgery and subsequent risk of NSCLC recurrence were included and then analyzed using RevMan 5.3.Results: Eleven studies were included in the meta-analysis involving 3,190 patients. The relationship between surgery and NSCLC recurrence was evaluated by pooled odds ratio (OR) and 95% confidence interval (CI). The results suggested that surgery does not increase the risk of NSCLC recurrence (OR =0.42, 95% CI, 0.25-0.72, P=0.001).Conclusions: Our results showed that surgery decreased the risk of NSCLC recurrence in stage I−IV.

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Recurrence and Risk Factors for Relapse in Patients with Non-Small Cell Lung Cancer Treated by Surgery with Curative Intent

Cited by 16 publications

References 19 publications

Prognostic Impact of PD-L1 Expression in pN1 NSCLC: A Retrospective Single-Center Analysis

Prognostic Impact of PD-L1 Expression in pN1 NSCLC: A Retrospective Single-Center Analysis

Pre-operative plasma cell-free circulating tumor DNA and serum protein tumor markers as predictors of lung adenocarcinoma recurrence

Surgery and subsequent risk of non-small cell lung cancer recurrence: a meta-analysis of observational studies

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