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Salvage surgery for advanced non-small cell lung cancer after targeted therapy: A case series
Weian Song1, Shouyin Di1, Junqiang Liu1
1Department of Thoracic Surgery, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China.
Background:
Tumor recurrence or residual tumor after targeted therapy is common in patients with advanced non-small cell lung cancer (NSCLC). There is a lack of high-level evidence on which type of treatment should be employed for these patients and the role of salvage surgery has not been well reported in the literature.
Methods:
A retrospective analysis of patients who underwent salvage surgery in our center between January 2016 and June 2019 for advanced NSCLC after targeted therapy was performed.
Results:
A total number of nine patients were identified, including five males and four females, with a median age of 56 years (range, 40-65 years), all diagnosed with lung adenocarcinoma stage IIIa-IVb. All patients had received targeted therapy according to individual positive mutation of driver gene(s). Salvage surgery was performed for tumor recurrence or residual tumor after a duration of 2-46 months of targeted therapy. A negative surgical margin was achieved in all cases. Postoperative complication rate was 11.1% (1/9). All patients were alive at the time of this analysis and two patients had disease progression. After a median follow-up of 17 months (range: 5-44 months), the median event-free survival and postoperative survival was 14 months (range: 2-44 months) and 17 months (range: 5-44 months) respectively.
Conclusions:
Salvage surgery may be a feasible and promising therapeutic option for tumor recurrence or residual tumor in advanced NSCLC in selective patients after targeted therapy.
Key Points:
Salvage surgery is feasible in selected patients with advanced NSCLC and provides promising survival outcomes after targeted therapy failure. Salvage surgery provides precise molecular and pathological information which is most important for subsequent therapy.
Insights
Salvage surgery is a viable option for advanced non-small cell lung cancer (NSCLC) patients with recurrent or residual tumors after targeted therapy. This approach shows promising survival outcomes and provides crucial information for further treatment in selected cases.
Area of Science:
- Oncology
- Surgical Oncology
- Thoracic Surgery
Background:
- Tumor recurrence or residual disease is common in advanced non-small cell lung cancer (NSCLC) following targeted therapy.
- There is limited high-level evidence guiding treatment decisions for these patients.
- The role of salvage surgery in advanced NSCLC after targeted therapy is not well-documented.
Purpose of the Study:
- To evaluate the feasibility and outcomes of salvage surgery in patients with advanced NSCLC.
- To assess the efficacy of salvage surgery for tumor recurrence or residual tumor after targeted therapy.
- To determine the survival benefits and complication rates associated with salvage surgery in this patient population.
Main Methods:
- Retrospective analysis of patients who underwent salvage surgery for advanced NSCLC between January 2016 and June 2019.
- Inclusion criteria: advanced NSCLC with tumor recurrence or residual tumor after targeted therapy.
- Data collected on patient demographics, treatment history, surgical outcomes, and survival.
Main Results:
- Nine patients with lung adenocarcinoma (Stage IIIa-IVb) were identified.
- All patients received targeted therapy prior to salvage surgery.
- Negative surgical margins were achieved in all cases, with a low postoperative complication rate (11.1%).
- Median follow-up was 17 months; median event-free survival was 14 months, and median postoperative survival was 17 months.
- All patients were alive at the time of analysis, with two experiencing disease progression.
Conclusions:
- Salvage surgery is a feasible and promising therapeutic option for selected patients with advanced NSCLC.
- It offers potential for improved survival outcomes in cases of targeted therapy failure.
- Provides critical molecular and pathological information for subsequent treatment planning.
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