Author of

• 32374

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  P2.13 - Staging (ID 315)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Staging
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 32378

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    P2.13-02 - Persistent Occult Micrometastases in Mediastinal Lymph Nodes Are Associated with Reduced Survival After Neoadjuvant Therapy (ID 1871)

    10:15 - 18:15  |  Author(s): Monika Pasieka-Lis
    • Abstract

    Background
    

    This study was undertaken to evaluate the utility of the detection of occult micrometastases (OM) by immunohistochemical (IHC) staining of mediastinal lymph nodes (LN) obtained during surgical restaging after neoadjuvant treatment of NSCLC patients with mediastinal LN metastases.

    Method
    

    In years 2007-2018, 55 patients with pathologically confirmed mediastinal LN metastases were restaged with TEMLA (transcervical extended mediastinal lymphadenectomy) after neoadjuvant chemotherapy or chemoradiotherapy. Routine haematoxylin&eosin staining of harvested mediastinal LN showed no metastases and all patients subsequently underwent curative pulmonary resection. To detect OM, we retrospectively performed IHC staining with anticytokeratin antibodies on all (1613) mediastinal LN obtained during TEMLA.

    Result
    

    Persistent OM were found in mediastinal LN of 7 patients (12,7%). In all cases, only single LN was affected. After a median observation period of 24 months (range 4 to 60) after curative surgery, OM+ patients showed significantly reduced overall survival in comparison to OM- patients (log-rank, p=0.035). In Cox multivariable analysis, OM persistence was independent negative factor for overall survival.

    Conclusion
    

    IHC staining of mediastinal LN obtained during TEMLA allows for more accurate restaging. Persistent mediastinal OM after neoadjuvant treatment are associated with reduced survival after pulmonary resection.