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A Single-Center Experience in Combined Oncological-Surgical Treatment for Resectable Locally Advanced Non-Small Cell
Dan Levy Faber1,2, Abed Agbarya2,3, Ben Caspy1,4
1Department of Cardiothoracic Surgery, Lady Davis Carmel Medical Center, 7 Michal St., Haifa 3436212, Israel.
Diseases (Basel, Switzerland)
|May 24, 2024
Summary
Locally advanced non-small cell lung cancer (NSCLC) patients treated with neoadjuvant therapy followed by surgery showed promising survival rates. Downstaging occurred in most patients, with a significant complete pathological response observed.
Area of Science:
- Oncology
- Thoracic Surgery
- Pulmonary Medicine
Background:
- Non-small cell lung cancer (NSCLC) is the most common lung malignancy.
- Locally advanced Stage IIIA NSCLC presents diagnostic and treatment challenges due to heterogeneous phenotypes and lack of clear guidelines.
- Combined oncological and surgical approaches are generally considered necessary for operable Stage IIIA NSCLC.
Purpose of the Study:
- To evaluate outcomes of operable Stage IIIA NSCLC patients treated with neoadjuvant therapy followed by surgery.
- To assess initial diagnosis, neoadjuvant regimens, surgical outcomes, and long-term survival.
- To analyze pathological staging changes and patterns of disease recurrence.
Main Methods:
- Retrospective descriptive study of operable Stage IIIA NSCLC patients undergoing surgery between 2013 and 2020.
- Analysis of patients receiving neoadjuvant oncological treatment (primarily chemoradiation) prior to surgery.
- Evaluation of post-operative pathological staging, including downstaging and complete pathological response.
- Assessment of 2-year and 5-year overall survival rates and recurrence patterns.
Main Results:
- Out of 35 patients receiving neoadjuvant treatment, 28 were diagnosed with Stage IIIA NSCLC.
- Post-operative pathological staging revealed downstaging in 19 patients (68%), with 25% achieving complete pathological response.
- The 2-year overall survival rate was 65%, and the 5-year overall survival rate was 62%.
- Distant metastasis was the predominant pattern of disease recurrence.
Conclusions:
- Neoadjuvant therapy followed by surgery is a viable approach for operable Stage IIIA NSCLC.
- Significant pathological downstaging and complete response rates indicate treatment efficacy.
- Achieved survival rates suggest a positive impact of this combined modality treatment.
- Further research into optimizing neoadjuvant strategies and managing distant recurrence is warranted.
Keywords:
chemotherapyimmunotherapylocally advanced stageneoadjuvant treatmentnon-small cell lung cancerradiotherapysurgeryMore Related Videos
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