Author of

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  P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 26873

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    P2.01-71 - Clinical Outcome of Induction Chemoradiotherapy Followed by Surgery for the Patients with cN2 Non-Small Cell Lung Cancer (ID 13091)

    16:45 - 18:00  |  Author(s): Yuta Takahashi
    • Abstract
    • Slides

    Background
    

    The treatment strategy for clinical N2 (cN2) non-small cell lung cancer (NSCLC) is still controversial, because its clinical outcome is unsatisfactory and cN2 NSCLC harbors various conditions. In this study, we investigated the clinical outcome of induction chemoradiotherapy (iCRT) followed by surgery in the patients with cN2 NSCLC.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    During 1999 to 2016, 92 patients with cN2 NSCLC were surgically treated after iCRT in our hospital. Overall survival (OS) and relapse-free survival (RFS) were evaluated by the Kaplan-Meier method with log-rank test (univariate analyses) and by the cox proportional hazard model (multivariate analyses).

    4c3880bb027f159e801041b1021e88e8 Result
    

    Median follow-up was 49.3 months (range 3.0 - 216). Median age was 62 (21 - 79). Sixty-nine patients (75%) were male. Fifty-four and 38 patients were cStageIIIA and IIIB, respectively. Forty-six (50%) patients were adenocarcinoma. As for iCRT, the CDDP plus DTX regimen was applied for most of patients (96.7%), and the median radiation dose was 46Gy (36 - 60). Complete/major/minor pathological responses were exhibited in 29/36/27 patients, respectively. pCR was observed in 22 patients. The 5-year rates of OS and RFS were 64.1% and 48.1%, respectively. The patients with lower-lobe origin, cStage IIIA (UICC8th), poor radiological response (progressive or stable disease), minor pathological response, re-operation within 30days after surgery, or recurrence showed significantly worse OS than the others. In addition, the patients with lower lobe origin, cStageIIIA, multi-station N2, poor radiological response, or minor pathological response showed significantly worse RFS. The multivariate analysis revealed that the patients with lower-lobe origin tumors and multi-station N2 showed significantly worse OS [Hazard Ratio (HR) 2.55, 95% confidence interval (CI) 1.11 - 5.71, P= 0.028] and RFS (HR 2.45, 95%CI 1.34 - 4.69, P= 0.003), respectively. Adenocarcinoma, lower-lobe origin, multi-station N2, cStageIIIA, poor radiological response, and minor pathological response significantly correlated to recurrence. Among them, adenocarcinoma (odds ratio (OR) 3.27, 95%CI 1.21 – 8.89, P= 0.02), lower-lobe origin (OR 5.22, 95%CI 1.48 – 18.40, P= 0.01), and multi-station N2 (OR 3.63, 95%CI 1.32 – 9.88, P= 0.012) independently correlated to recurrence.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    iCRT followed by surgery may be one of the feasible treatment options for the patients with cN2-NSCLCs, especially for those which harbor non-lower lobe origin and multi-station N2 .

    6f8b794f3246b0c1e1780bb4d4d5dc53

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