Neoadjuvant Therapy and Factors Influencing Survival in Locally Advanced Non-Small Cell Lung Cancer

Area of Science:

• Oncology
• Thoracic Surgery
• Medical Oncology

Background:

• Locally advanced non-small cell lung cancer (NSCLC) presents a therapeutic challenge.
• Neoadjuvant therapy (NAT) is a strategy to improve resectability and survival outcomes.
• Understanding the impact of post-NAT treatment on survival is crucial for optimizing patient care.

Purpose of the Study:

• To evaluate the effectiveness of neoadjuvant therapy (NAT) in locally advanced non-small cell lung cancer (NSCLC) stages IIIA-IIIB.
• To analyze clinicopathological characteristics associated with treatment response.
• To determine the influence of post-NAT treatment modalities on overall survival (OS) and failure-free survival (FFS).

Main Methods:

• Retrospective review of 57 patients with locally advanced NSCLC who received NAT between 2004 and 2020.
• Analysis of clinicopathological and radiological data.
• Evaluation of OS and FFS based on post-NAT treatment (chemotherapy, chemoradiotherapy, surgery).

Main Results:

• Surgery as a post-NAT modality significantly improved FFS (16 months) and OS (55 months) compared to chemotherapy or chemoradiotherapy.
• Patients undergoing surgery demonstrated a longer FFS (HR: 0.33) and OS (HR: 0.36).
• Five-year survival rates were notably higher in the surgery group (40%) versus chemoradiotherapy (21.4%) and chemotherapy (14.3%).

Conclusions:

• Achieving operable status after NAT is a critical determinant of survival in locally advanced NSCLC.
• Surgical intervention post-NAT confers a significant survival advantage over non-surgical treatment options.
• These findings emphasize the importance of surgical resection in improving long-term outcomes for selected NSCLC patients.