Health Sciences University Bakırköy Dr. SadiKonuk Training and Research Hospital, Thoracic Surgery Clinic, ZuhuratbabaMah, Dr. TevfikSağlam Cd No:11, Bakırköy, İstanbul, 34147, Türkiye.
Gen Thorac Cardiovasc Surg. 2021 Jul;69(7):1086-1095. doi: 10.1007/s11748-020-01584-z. Epub 2021 Jan 15.
The first aim is to determine the clinical and pathological characteristics and factors affecting survival in patients with pathological complete response (pCR) after neoadjuvant therapy, and the secondary aim is to investigate the effect of adjuvant therapy on survival in these patients.
Between 2003 and 2015, there was 372 patients who underwent lung resection after neoadjuvant therapy with a diagnosis of locally advanced lung cancer. Sixty-eight patients who had pCRwere retrospectively analyzed. The odds ratios (OR) were calculated in regards of recurrence.
Overall 5-year survival rate was 65.1%. Recurrence was the risk factor affecting survival (78.2% vs 19.3%, p = 0.001) while neoadjuvant treatment type (p = 0.766), the reason of neodjuvant treatment (p = 0.581), and the type of operation (p = 0.860) did not affect survival. Postoperative adjuvant treatment had a positive effect on survival (71.1% versus 62.7%), although this difference was not significant (p = 0.561). Local or distant recurrence was detected in 15 patients (22%). In multivariate analysis, the independent risk factors affecting the recurrence were the time from the end of the neoadjuvant therapy to the surgery being less than eight weeks (OR = 6.49, p = 0.03), the type of neoadjuvant treatment (OR = 0.203, p = 0.03). In patients with a squamous cell carcinoma, there was a decreased trend toward in terms of recurrence (p = 0.06).
pCR after neoadjuvant therapy positively affects survival. Better survival may be detected in patients receiving adjuvant therapy. Due to unexpected the high recurrence rate, patients should be followed in the postoperative period closely.
一是确定新辅助治疗后病理完全缓解（pCR）患者的临床和病理特征及影响生存的因素，二是探讨辅助治疗对这些患者生存的影响。
2003 年至 2015 年，372 例局部晚期肺癌患者接受新辅助治疗后行肺切除术，回顾性分析其中 68 例 pCR 患者。计算复发相关的比值比（OR）。
总体 5 年生存率为 65.1%。复发是影响生存的危险因素（78.2%比 19.3%，p=0.001），而新辅助治疗类型（p=0.766）、新辅助治疗原因（p=0.581）和手术类型（p=0.860）不影响生存。术后辅助治疗对生存有积极影响（71.1%比 62.7%），但差异无统计学意义（p=0.561）。15 例（22%）患者检测到局部或远处复发。多因素分析显示，影响复发的独立危险因素是新辅助治疗结束至手术的时间少于 8 周（OR=6.49，p=0.03）和新辅助治疗类型（OR=0.203，p=0.03）。在鳞状细胞癌患者中，复发的趋势有所降低（p=0.06）。
新辅助治疗后 pCR 对生存有积极影响。接受辅助治疗的患者可能会有更好的生存。由于复发率高，患者在术后应密切随访。
