Major pathologic response assessment and clinical significance of metastatic lymph nodes after neoadjuvant therapy for non-small cell lung cancer
| Autor: | Yue Yang, Xin Yang, Wei Sun, Kaiwen Chi, Yuan Feng, Xinying Liu, Dongmei Lin, Jianghua Wu, Luning Mao, Haiyue Wang, Mailin Chen |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
Male Pathology medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Disease-Free Survival Pathology and Forensic Medicine Targeted therapy Major Pathologic Response Internal medicine Carcinoma Non-Small-Cell Lung Medicine Humans Clinical significance Lung cancer Lymph node Neoadjuvant therapy Retrospective Studies business.industry Middle Aged medicine.disease Primary tumor Neoadjuvant Therapy Survival Rate medicine.anatomical_structure Lymphatic Metastasis Adenocarcinoma Lymph Node Excision Female Lymph Nodes business |
| Zdroj: | Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc. 34(11) |
| ISSN: | 1530-0285 |
| Popis: | For neoadjuvant therapy in patients with non-small cell lung cancer, the major pathologic response of primary tumors may be an assessable and reliable surrogate measure of survival. Few studies have examined the pathologic evaluation of metastatic lymph node responses and their prognostic significance. This retrospective study enrolled 336 patients with non-small cell lung cancer (squamous cell carcinoma, n = 216; adenocarcinoma, n = 120) treated with neoadjuvant therapy including chemotherapy (n = 316) and targeted therapy (adenocarcinoma, n = 20). The treatment response of the primary tumor and lymph node metastases (LNM) were pathologically assessed according to the multidisciplinary recommendations of the International Association for the Study of Lung Cancer. The relationship of overall survival (OS) and disease-free survival (DFS) with the responses of the primary tumor or LNM was analyzed. The optimal cutoff value of the residual viable tumor (%RVT) of the primary tumor was 12% for both OS (P < 0.001) and DFS (P < 0.001). The pathologic assessment identified LNM in 208 patients. The optimal %RVT cutoff value in LNM was 8% for both OS (P = 0.003) and DFS (P < 0.001). The Spearman's rank correlation coefficient between primary tumors and corresponding LNM was 0.487 for %RVT (P < 0.001), which indicated a positive correlation. On multivariable analysis, an RVT of the primary tumor ≤12% was an independent prognostic factor for improved OS (P = 0.024), whereas an RVT of LNM ≤ 8% was an independent prognostic factor for increased DFS (P = 0.018). Furthermore, in the neoadjuvant chemotherapy group, the optimal %RVT cutoff values for OS in patients with squamous cell carcinoma and adenocarcinoma in the primary tumor were 12% and 58%, respectively. Considering its convenience and operability in clinical application, a 10% threshold RVT value can be used for prognostic evaluation of LNM and primary tumors of squamous cell carcinoma histology; further studies are needed to confirm the optimal cutoff value for primary tumors of adenocarcinoma. |
| Databáze: | OpenAIRE |
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