Lungscape: resected non-small-cell lung cancer outcome by clinical and pathological parameters
Solange Peters1, Walter Weder, Urania Dafni
1*Centre Hospitalier Universitaire de Vaud, Lausanne, Switzerland; †Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland; ‡Frontier Science Foundation-Hellas & University of Athens, Athens, Greece; §Aberdeen Royal Infirmary, Aberdeen, United Kingdom; ‖Institute for Pathology, University Hospital Basel, Basel, Switzerland; ¶Department of Oncology, University Hospital, Aarhus, Denmark; #Department of Medical Oncology, St. James's Hospital, Dublin, Ireland; **Medical University of Gdansk, Gdansk, Poland; ††University Hospital KU Leuven, Leuven, Belgium; ‡‡Vall d'Hebron University Hospital, Barcelona, Spain; §§Center of Predictive Molecular Medicine, University Foundation, Chieti, Italy; ‖‖Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China; ¶¶VU University Medical Center, Amsterdam, Netherlands; ##Maastricht University Medical Centre, Maastricht, Netherlands; ***Manchester University and The Christie National Health Services Foundation Trust, Manchester, United Kingdom; †††Netherlands Cancer Institute, Amsterdam, Netherlands; ‡‡‡Department of Medicine, University of Valencia and Department of Medical Oncology, General University Hospital of Valencia, Valencia, Spain; §§§Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain; and ‖‖‖Clinic of Oncology, University Hospital Zurich, Zurich, Switzerland.
Introduction:
The Lungscape project was designed to address the impact of clinical, pathological, and molecular characteristics on outcome in resected non-small- cell lung cancer (NSCLC).
Materials And Methods:
A decentralized biobank with fully annotated tissue samples was established. Selection criteria for participating centers included sufficient number of cases, tissue microarray building capability, and documented ethical approval. Patient selection was based on availability of comprehensive clinical data, radical resection between 2003 and 2009 with adequate follow-up, and adequate quantity and quality of formalin-fixed tissue.
Results:
Fifteen centers contributed 2449 cases. The 5-year overall survival (OS) was 69.6% and 63.6% for stages IA and IB, 51.6% and 47.7% for stages IIA and IIB, and 29.0% and 13.0% for stages IIIA and IIIB, respectively (p < 0.001). Median and 5-year relapse-free survival (RFS) were 52.8 months and 47.3%, respectively. Distant relapse was recorded for 44.4%, local for 26.0%, and both for 16.9% of patients. Based on multivariate analysis for the OS, RFS, and time to relapse, the factors significantly associated with all of them are performance status and pathological stage.
Conclusion:
The aim of this report is to present the results from Lungscape, the first large series reporting on NSCLC surgical outcome measured not only by OS but also by RFS and time to relapse and including multivariate analysis by significant clinical and pathological prognostic parameters. As tissue from all patients is preserved locally and is available for detailed molecular investigations, Lungscape provides an excellent basis to evaluate the influence of molecular parameters on the disease outcome after radical resection, besides providing an overview of the molecular landscape of stage I to III NSCLC.
