Damirov Fuad, Stoleriu Mircea Gabriel, Manapov Farkhad, Boedeker Enole, Dreher Sascha, Gerz Sibylle, Hehr Thomas, Sandner Evelin, Ott German, Hatz Rudolf Alexander, Preissler Gerhard
Department of Thoracic Surgery, Ludwig Maximilian University of Munich (LMU) and Asklepios Lung Clinic, Munich-Gauting, 82131 Gauting, Germany.
Department of Thoracic Surgery, RBK-Lungenzentrum Stuttgart, Schillerhöhe Lung Clinic, Robert Bosch Hospital, 70376 Stuttgart, Germany.
Cancers (Basel). 2024 Aug 20;16(16):2885. doi: 10.3390/cancers16162885.
Our study aimed to identify predictors for the effectiveness of tumor regression in lung cancer patients undergoing neoadjuvant treatment and cancer resections. Patients admitted between 2016 and 2022 were included in the study. Based on the histology of the tumor, patients were categorized into a lung adenocarcinoma group (LUAD) and squamous cell carcinoma group (SQCA). Ninety-five patients with non-small-cell lung cancer were included in the study. A total of 58 (61.1%) and 37 (38.9%) patients were included in the LUAD and SQCA groups, respectively. Additionally, 9 (9.5%), 56 (58.9%), and 30 (31.6%) patients were categorized with a tumor regression score of I, II, and III, respectively. In multivariable analyses, histology of the primary tumor (SQCA), lymph node size in the preoperative CT scan (>1.7 cm), and absolute tumor size reduction after neoadjuvant treatment (>2.6 cm) independently predict effectiveness of tumor regression (OR [95% confidence interval, p-value] of 6.88 [2.40-19.77, 0.0001], 3.13 [1.11-8.83, 0.0310], and 3.76 [1.20-11.81, 0.0233], respectively). Age > 70 years, extended resection > one lobe, and tumor recurrence or metastasis were identified as significant independent predictors of reduced overall survival. Assessment of tumor size before and after neoadjuvant treatment might help to identify high-risk patients with decreased survival and to improve patient management and care.
我们的研究旨在确定接受新辅助治疗和癌症切除术的肺癌患者肿瘤消退有效性的预测因素。2016年至2022年期间入院的患者纳入本研究。根据肿瘤组织学,患者被分为肺腺癌组(LUAD)和鳞状细胞癌组(SQCA)。本研究纳入了95例非小细胞肺癌患者。LUAD组和SQCA组分别纳入了58例(61.1%)和37例(38.9%)患者。此外,肿瘤消退评分为I、II和III级的患者分别为9例(9.5%)、56例(58.9%)和30例(31.6%)。在多变量分析中,原发肿瘤组织学(SQCA)、术前CT扫描中的淋巴结大小(>1.7 cm)以及新辅助治疗后肿瘤绝对大小缩小(>2.6 cm)独立预测肿瘤消退的有效性(OR[95%置信区间,p值]分别为6.88[2.40 - 19.77,0.0001]、3.13[1.11 - 8.83,0.0310]和3.76[1.20 - 11.81,0.0233])。年龄>70岁、扩大切除>一个肺叶以及肿瘤复发或转移被确定为总生存期降低的显著独立预测因素。评估新辅助治疗前后的肿瘤大小可能有助于识别生存降低的高危患者,并改善患者管理和护理。