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Microscopic (R1) and macroscopic (R2) residual disease in patients with resected non-small cell lung cancer
H S Hofmann1, C Taege, C Lautenschläger
1Department of Cardio-Thoracic Surgery, Martin Luther University, E.-Grube Strasse 40, 06097 Halle, Germany. stefan.hofmann@medizin.uni-halle.de
Summary
Patients with microscopic residual disease after non-small cell lung cancer (NSCLC) resection had a 14% survival rate. Macroscopic residual disease (R2) resulted in no long-term survival, indicating palliative care is necessary.
Area of Science:
- Oncology
- Thoracic Surgery
- Cancer Research
Background:
- Non-small cell lung cancer (NSCLC) resection aims for curative intent.
- Residual disease at resection margins (R1/R2) impacts patient outcomes.
- Understanding survival probabilities for R1/R2 disease is crucial for treatment planning.
Purpose of the Study:
- To evaluate the survival probability in patients with non-small cell lung cancer (NSCLC) after resection.
- To analyze outcomes based on the presence and type of residual disease at resection margins (R1 microscopic, R2 macroscopic).
Main Methods:
- Retrospective study of 596 patients undergoing NSCLC resection with curative intent over 6 years.
- Categorization of residual disease into microscopic (R1) and macroscopic (R2).
- Analysis of survival rates, including 30-day lethality and 5-year survival, stratified by R1/R2 status and disease characteristics.
Main Results:
- 4.4% of patients had R1 (microscopic residual disease) and 2% had R2 (macroscopic residual disease).
- The 5-year survival rate for R1 resection was 14%; no R2 patients survived the first year.
- Adjuvant radiation showed no survival benefit, particularly in N2 disease patients.
Conclusions:
- Patients with R1 NSCLC have a 14% survival rate, similar to R0 resections in stage III.
- Adjuvant radiation therapy does not appear to improve survival in this context.
- Macroscopic residual disease (R2) necessitates palliative treatment strategies post-operation.