초록접수 현황
| 20F-182 | 구연 발표 |
Validation of the Proposed IASLC Residual Tumor Classification in Patients with N2 Non-small Cell Lung Cancer after Neoadjuvant Concurrent Chemoradiotherapy followed by surgery
Junghee Lee, Sumin Shin, Jong Ho Cho, Yong Soo Choi, Jhingook Kim, Jae Ill Zo, Young Mog Shim, Hong Kwan Kim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, SungKyunKwan University School of Medicine, Seoul, Republic of Korea
Purpose : Aim of this study is to validate the proposed international association for the study of lung cancer (IASLC) R descriptor in patients with N2 Non-small cell lung cancer after neoadjuvant therapy followed by surgery.
Methods : Using an institutional cohort of patients with N2 NSCLC from 2004-2018, the residual tumor status was classified by Union for International Cancer Control (UICC) and IASLC residutal tumor classification criteria. We compared the distribution of R classification variables and their survival associations.
Results : : The study cohort consisted of 869 patients. Of them, 832 (95.7%) were R0, 35 (4.0%) were R1, and 2 (0.2%) were R2 by UICC criteria; 277 (31.9%) were R0, 321 (36.9%) were uncertain resection [R (un)], and 271 (31.2%) were R1/R2 by IASLC criteria. The UICC R0 redistributed to the IASLC R(un) in 321(38.6%), and to IASLC R1/R2 in 234 (28.1%). Causes of redistribution to IASLC R(un) are inadequate lymph node assessment in 87.2% and metastasis to the highest mediastinal node station in 15.3%, whereas causes of redistrubtion to IASlC R1/R2 are extracapsular extension of positive lymph nodes in 76.1% non-removal of known positive nodes in 29.9%, and positive resection margin in 13.7%. The overall survival rates at 5 year were 57.2% in IASLC R0, 49.6% in R(un), and 46.9% in R1/R2 (p=0.044). The recurrence-free survival rates at 5 year were 51.3%, 37.4%, and 25.9%, respectively (p<.001).
Conclusion : The proposed R descriptors have prognostic relevance, with R(un) survival stratifying between R0 and R1.
Methods : Using an institutional cohort of patients with N2 NSCLC from 2004-2018, the residual tumor status was classified by Union for International Cancer Control (UICC) and IASLC residutal tumor classification criteria. We compared the distribution of R classification variables and their survival associations.
Results : : The study cohort consisted of 869 patients. Of them, 832 (95.7%) were R0, 35 (4.0%) were R1, and 2 (0.2%) were R2 by UICC criteria; 277 (31.9%) were R0, 321 (36.9%) were uncertain resection [R (un)], and 271 (31.2%) were R1/R2 by IASLC criteria. The UICC R0 redistributed to the IASLC R(un) in 321(38.6%), and to IASLC R1/R2 in 234 (28.1%). Causes of redistribution to IASLC R(un) are inadequate lymph node assessment in 87.2% and metastasis to the highest mediastinal node station in 15.3%, whereas causes of redistrubtion to IASlC R1/R2 are extracapsular extension of positive lymph nodes in 76.1% non-removal of known positive nodes in 29.9%, and positive resection margin in 13.7%. The overall survival rates at 5 year were 57.2% in IASLC R0, 49.6% in R(un), and 46.9% in R1/R2 (p=0.044). The recurrence-free survival rates at 5 year were 51.3%, 37.4%, and 25.9%, respectively (p<.001).
Conclusion : The proposed R descriptors have prognostic relevance, with R(un) survival stratifying between R0 and R1.
첨부파일 : Rfactor_neo.pdf
책임저자: Hong Kwan Kim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, SungKyunKwan University School of Medicine, Seoul, Republic of Korea
발표자: Junghee Lee, E-mail : ts.junghee@gmail.com