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S. Andersson

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    P1.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 212)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P1.03-001 - Survival of the NSCLC Patients with Clinical Stage IIIA Disease with N2 Involvement: Case-Control Study with Emphasis on Treatment Modality (ID 1074)

      09:30 - 17:00  |  Author(s): S. Andersson

      • Abstract
      • Slides

      The aim of this study was to determine the survival rate of patients with non-small cell lung cancer (NSCLC) who were preoperatively diagnosed with positive N2 lymph node and compare survival with chemo- or chemoradiotherapy treated patients to surgically operated patients, with or without preoperative chemoradiation therapy.

      Study included two patient groups. Operative patient group consisted of 74 clinical Stage IIIA patients with cN2 lymph node involment, from a 1105 patient cohort, who were operated between January 2000 and December 2014. Definitive chemoradiation group consisted of 49 Stage IIIA NSCLC patients that were treated between September 2008 and October 2014. Institutional tumour board was used to evaluate operative treatment. Routine positron emission tomography (PET) was established in 2006 at our institution.

      37 had preoperative mediastinoscopy, 66 PET-CT and 24 received both. In the operative patient group, adjuvant chemotherapy was administered 25 and chemoradiation to 7 patients. No differences were observed between patient groups in age or Charlson Co-morbidity Index. A total of 47 operated patients were downstaged to pathological N0 or N1 disease and pathological N2 disease was observed in 27 patients, of 11 patients had multi-level N2 involvement. Median survival for pN0/1 was 47 months, pN2 15 months and definitive chemoradiation 19 months. Survival for pathological N-stage is presented in Figure 1, and for preoperative therapy in Figure 2. Figure 1Figure 2

      Operative treatment for clinically suspected N2 disease is feasible option if patients are downstaged to pathological N0 or N1 with means of chemoradiation therapy or pre- or intraoperative frozen sections. Surgery for pathological N2 disease has no survival advantage over definitive chemoradiation and should be discouraged.

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