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Decision-to-outcome analysis of multidisciplinary tumor board-managed NSCLC patients
Erhan Özer1, Hüseyin Melek1, Adem Deligönül2
1Department of Thoracic Surgery, Bursa Uludağ University Faculty of Medicine, Bursa, Türkiye.
Background:
Neoadjuvant therapy is recommended for selected patients with non-small cell lung cancer; however, concerns about disease progression, loss of surgical opportunity, and treatment-related mortality limit its adoption. Multidisciplinary tumor board (MDT) aims to optimize treatment sequencing, yet comprehensive real-world data integrating treatment-related and oncologic outcomes remain limited. This study evaluated progression, resection rates, treatment-related mortality, and long-term oncologic outcomes within a multidisciplinary management framework.
Methods:
This retrospective cohort included 769 patients discussed by a thoracic oncology board between May 2015 and November 2019. Treatment strategies comprised upfront surgery, neoadjuvant therapy followed by planned surgery, definitive chemoradiotherapy, or non-surgical management. The primary outcome was progression during neoadjuvant therapy. Secondary outcomes included resection rates, treatment-related mortality, pathological response, and overall survival.
Results:
Neoadjuvant therapy was recommended in 275 patients (35.8%). Disease progression occurred in 8 patients (2.9%). Curative-intent resection was achieved in 246 patients (89.5%). Treatment-related mortality during neoadjuvant therapy was 1.1%, compared with 5.3% after definitive chemoradiotherapy and 0.4% overall surgical mortality. Pathological complete response was observed in 13.4%. Among stage III patients, five-year overall survival was 69.0% in the neoadjuvant surgery group versus 20.0% in the non-surgical group.
Conclusion:
In this MDT-managed non-small cell lung cancer cohort, low progression rates and high resection rates were observed among patients selected for neoadjuvant therapy. These findings describe real-world treatment completion and clinical outcomes within a multidisciplinary management framework.
Insights
Neoadjuvant therapy for non-small cell lung cancer, guided by multidisciplinary tumor boards, shows low progression rates (2.9%) and high resection success (89.5%). This approach optimizes treatment sequencing and improves survival outcomes in selected patients.
Area of Science:
- Oncology
- Thoracic Surgery
- Cancer Treatment
Background:
- Neoadjuvant therapy for non-small cell lung cancer (NSCLC) is underutilized due to concerns about progression and mortality.
- Multidisciplinary tumor boards (MDTs) aim to optimize treatment sequencing but real-world data are limited.
- This study evaluates outcomes of NSCLC patients managed within an MDT framework.
Purpose of the Study:
- To assess the real-world effectiveness of neoadjuvant therapy in NSCLC.
- To evaluate progression rates, resection success, and treatment-related mortality.
- To analyze long-term oncologic outcomes, including overall survival.
Main Methods:
- Retrospective cohort study of 769 NSCLC patients discussed in a thoracic oncology board (May 2015-Nov 2019).
- Treatment strategies included upfront surgery, neoadjuvant therapy with surgery, chemoradiotherapy, or non-surgical management.
- Primary outcome: progression during neoadjuvant therapy; Secondary outcomes: resection rates, mortality, pathological response, overall survival.
Main Results:
- Neoadjuvant therapy was recommended for 35.8% of patients, with only 2.9% experiencing progression.
- Curative-intent resection was achieved in 89.5% of eligible patients.
- Five-year overall survival for Stage III patients was 69.0% in the neoadjuvant surgery group versus 20.0% in the non-surgical group.
Conclusions:
- MDT-selected NSCLC patients undergoing neoadjuvant therapy demonstrate low progression rates and high resection rates.
- This approach facilitates treatment completion and yields favorable oncologic outcomes in real-world settings.
- Neoadjuvant therapy within an MDT framework is a viable strategy for selected NSCLC patients.
