Extended resection for potentially operable patients with stage III non-small cell lung cancer after induction treatment
| Autor: | Katarzyna Furrer, Walter Weder, Eric Innocents Eboulet, Daniel Betticher, Miklos Pless, Roger Stupp, Thorsten Krueger, Jean Yannis Perentes, Ralph A. Schmid, Didier Lardinois, Markus Furrer, Martin Früh, Solange Peters, Alessandra Curioni-Fontecedro, Rolf A. Stahel, Sacha I. Rothschild, Stefanie Hayoz, Isabelle Opitz |
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| Přispěvatelé: | University of Zurich, Opitz, Isabelle |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Lung Neoplasms 10255 Clinic for Thoracic Surgery 610 Medicine & health Chemoradiotherapy Middle Aged 2705 Cardiology and Cardiovascular Medicine 2746 Surgery Treatment Outcome 2740 Pulmonary and Respiratory Medicine Carcinoma Non-Small-Cell Lung Humans Female Surgery Prospective Studies Pneumonectomy Cardiology and Cardiovascular Medicine Neoplasm Staging |
| Popis: | OBJECTIVE Surgical treatment of locally advanced non-small cell lung cancer including single or multilevel N2 remains a matter of debate. Several trials demonstrate that selected patients benefit from surgery if R0 resection is achieved. We aimed to assess resectability and outcome of patients with locally advanced clinical T3/T4 (American Joint Committee on Cancer 8th edition) tumors after induction treatment followed by surgery in a pooled analysis of 3 prospective multicenter trials. METHODS A total of 197 patients with T3/T4 non-small cell lung cancer of 368 patients with stage III non-small cell lung cancer enrolled in the Swiss Group for Clinical Cancer Research 16/96, 16/00, 16/01 trials were treated with induction chemotherapy or chemoradiation therapy followed by surgery, including extended resections. Univariable and multivariable analyses were applied for analysis of outcome parameters. RESULTS Patients' median age was 60 years, and 67% were male. A total of 38 of 197 patients were not resected for technical (81%) or medical (19%) reasons. A total of 159 resections including 36 extended resections were performed with an 80% R0 and 13.2% pathological complete response rate. The 30- and 90-day mortality were 3% and 7%, respectively, without a difference for extended resections. Morbidity was 32% with the majority (70%) of minor grading complications. The 3-, 5-, and 10-year overall survivals for extended resections were 61% (95% confidence interval, 43-75), 44% (95% confidence interval, 27-59), and 29.5% (95% confidence interval, 13-48), respectively. R0 resection was associated with improved overall survival (hazard ratio, 0.41; P |
| Databáze: | OpenAIRE |
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