Akyıl Mustafa, Tezel Çağatay, Tokgöz Akyıl Fatma, Gürer Deniz, Evman Serdar, Alpay Levent, Baysungur Volkan, Yalçınkaya İrfan
Department of Thoracic Surgery, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Department of Pulmonary Diseases, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Jan 23;28(1):166-174. doi: 10.5606/tgkdc.dergisi.2020.18240. eCollection 2020 Jan.
This study aims to investigate the factors associated with pathological complete response following neoadjuvant treatment and to examine the prognostic value of pathological complete response in patients with non-small cell lung cancer undergoing surgical resection.
Between February 2009 and January 2016, a total of 112 patients (96 males, 16 females; mean age 60±8 years; range, 37 to 85 years) with the diagnosis of non-small cell lung cancer who underwent anatomical pulmonary resection after neoadjuvant treatment were retrospectively analyzed. Demographic, clinical, radiological, and pathological characteristics of the patients were recorded. The patients were classified as pathological complete response and nonpathological complete response according to the presence of tumors in the pathology reports. Predictive factors for pathological complete response and its prognostic significance were analyzed.
The mean follow-up was 35±20 (range, 0 to 110) months. Of the patients, 30 (27%) achieved a pathological complete response. Reduction rate in tumor size was significantly higher in the responsive group (32.5±21.6% vs. 19.2±18.8%, respectively) and was a predictor of pathological complete response independent from the T and N factors (p=0.004). Survival of the responsive patients was significantly longer than unresponsive patients (75±9 vs. 30±4 months, respectively; p<0.001). During follow-up, tumor recurrence was seen in 30 patients. Recurrence was observed in only one patient in the responsive group, while 29 patients in the unresponsive group had recurrence or metastasis.
Tumor shrinkage rate after neoadjuvant treatment in non-small cell lung cancer is a predictive factor for pathological complete response. Survival of patients with a pathological complete response is also significantly longer than unresponsive patients.
本研究旨在探讨新辅助治疗后病理完全缓解的相关因素，并检验病理完全缓解对接受手术切除的非小细胞肺癌患者的预后价值。
回顾性分析2009年2月至2016年1月期间，112例诊断为非小细胞肺癌且在新辅助治疗后接受解剖性肺切除的患者（96例男性，16例女性；平均年龄60±8岁；范围37至85岁）。记录患者的人口统计学、临床、影像学和病理特征。根据病理报告中肿瘤的存在情况，将患者分为病理完全缓解组和非病理完全缓解组。分析病理完全缓解的预测因素及其预后意义。
平均随访时间为35±20（范围0至110）个月。其中30例（27%）患者达到病理完全缓解。反应组的肿瘤大小缩小率显著更高（分别为32.5±21.6%和19.2±18.8%），且是独立于T和N因素的病理完全缓解预测指标（p=0.004）。反应组患者的生存期显著长于无反应组患者（分别为75±9个月和30±4个月；p<0.001）。随访期间，30例患者出现肿瘤复发。反应组仅1例患者复发，而无反应组29例患者出现复发或转移。
非小细胞肺癌新辅助治疗后的肿瘤缩小率是病理完全缓解的预测因素。病理完全缓解患者的生存期也显著长于无反应患者。
