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Alberto Sandri



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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      77P - The prognostic impact of the international association for the study of lung cancer (IASLC) definitions on completeness of surgical resection for non-small cell lung cancer (NSCLC) (ID 380)

      12:30 - 13:00  |  Author(s): Alberto Sandri

      • Abstract
      • Slides

      Background

      To reappraise the prognostic significance of the IASLC definitions of complete, uncertain, and incomplete resection in NSCLC surgery.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Single-institution retrospective review of 1052 consecutive patients surgically treated for NSCLC between 2008 and 2017. Complete resection was defined by absence of residual disease; systematic nodal dissection; no extracapsular extension in lymph nodes removed separately or those at lung specimen margin; negativity of distal mediastinal lymph nodes. An uncertain resection was defined by free resection margins, but one of the following applied: inadequate lymph node assessment; positivity of distal mediastinal lymph nodes; presence of carcinoma in situ at bronchial margin; positive pleural lavage cytology. A resection was defined incomplete by presence of residual disease; extracapsular extension in distal mediastinal lymph nodes or those at lung specimen margin; positive cytology of pleural or pericardial effusions. Follow-up was complete and overall survival (OS) was assessed using the Kaplan-Meier method and Cox proportional hazard modeling.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Eight hundred eighty-six (84.2%) patients had a complete resection, 131 (12.5%) an uncertain resection, and 35 (3.3%) an incomplete resection. Median follow-up was 44.9 months (range, 0.1 to 132.3). Complete resection was associated with significantly better survival compared to uncertain and incomplete resection (adjusted hazard ratio, 1.84 and 2.31, respectively; both p = 0.0001). Median OS and 5-year survival rate were 102.3, 32.9, 23.3 months and 62.3%, 33.5%, 24.3% in patients undergoing complete, uncertain, and incomplete resection, respectively. Additional significant predictors for OS in the multivariable Cox model were patient age and Charlson Comorbidity Index; tumor diameter, histology and pathologic TNM stage; and the occurrence of postoperative adverse events.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Our current experience confirms that in NSCLC surgery, significant differences exist in long-term survival following complete, uncertain, and incomplete resection, as defined by the IASLC.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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