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Using 22C3 Anti-PD-L1 Antibody Concentrate on Biopsy and Cytology Samples from Non-small Cell Lung Cancer Patients
Published on: September 25, 2018
Factors associated with upstaging in patients with resectable non-small cell lung cancer: a modern institutional
Sneha S Alaparthi1, Hamza Rshaidat1, Luke Meredith1
1Division of Esophageal and Thoracic Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Background:
There is significant value in predicting and better assessing patients who are at risk of post-surgery upstaging in lung cancer. The objective of this study is to review patients who were upstaged following resection and evaluate their clinical and demographic data to elucidate which factors portend an increased risk of pathologic upstaging at our institution (the Thomas Jefferson University Hospital).
Methods:
A retrospective review of institutional data was performed between 2011 and 2023. Patients with stage I-II non-small cell lung cancer (NSCLC) were included. Patients were excluded if they received neoadjuvant systemic therapy, including chemotherapy and/or immunotherapy, and were excluded if they received pre-operative mediastinoscopy or endobronchial ultrasound (EBUS). Kaplan-Meier analysis was utilized with log-rank testing to examine 5-year overall survival and progression-free survival. A logistic regression model was built to evaluate whether certain clinical or demographic factors affect the odds of being upstaged.
Results:
A total of 371 patients met the inclusion criteria. Male sex, primary tumor standardized uptake value (SUV) >8, pre-operative biopsy, and having 10-13 lymph nodes explored were all associated with increased odds of being upstaged. Squamous cell histology was associated with lower odds of upstaging compared to adenocarcinoma. Patients who had their tumor detected via a screening computed tomography (CT) scan had a trend towards a decreased odds of upstaging compared to symptomatic and incidentally found tumors.
Conclusions:
Male gender, primary tumor SUV >8, having a preoperative biopsy, and having 10-13 lymph nodes explored were associated with increased odds of being upstaged. This analysis provides patients and clinicians with valuable data regarding upstaging early-stage lung cancers, which could be used to guide multidisciplinary teams in making more informed decisions regarding resection and the use of perioperative systemic therapy.
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