View : 201 Download: 0
Validation of the IASLC Residual Tumor Classification in Patients with Stage III-N2 Non-Small Cell Lung Cancer Undergoing Neoadjuvant Chemoradiotherapy Followed by Surgery
- Title
- Validation of the IASLC Residual Tumor Classification in Patients with Stage III-N2 Non-Small Cell Lung Cancer Undergoing Neoadjuvant Chemoradiotherapy Followed by Surgery
- Authors
- Lee J.; Hong Y.S.; Lee G.; Kang D.; Yun J.; Jeon Y.J.; Shin S.; Cho J.H.; Choi Y.S.; Kim J.; Zo J.I.; Shim Y.M.; Guallar E.; Cho J.; Kim H.K.
- Ewha Authors
- 신수민
- SCOPUS Author ID
- 신수민
- Issue Date
- 2023
- Journal Title
- Annals of Surgery
- ISSN
- 0003-4932
- Citation
- Annals of Surgery vol. 277, no. 6, pp. E1355 - E1363
- Keywords
- lung cancer; N2; neoadjuvant concurrent chemoradiotherapy; residual tumor; surgery
- Publisher
- Wolters Kluwer Health
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Objective: The aim of this study was to validate the International Association for the Study of Lung Cancer (IASLC) residual tumor classification in patients with stage III-N2 non-small cell lung cancer (NSCLC) undergoing neoadjuvant concurrent chemoradiotherapy (nCCRT) followed by surgery. Background: As adequate nodal assessment is crucial for determining prognosis in patients with clinical N2 NSCLC undergoing nCCRT followed by surgery, the new classification may have better prognostic implications. Methods: Using a registry for thoracic cancer surgery at a tertiary hospital in Seoul, Korea, between 2003 and 2019, we analyzed 910 patients with stage III-N2 NSCLC who underwent nCCRT followed by surgery. We classified resections using IASLC criteria: complete (R0), uncertain (R[un]), and incomplete resection (R1/R2). Recurrence and mortality were compared using adjusted subdistribution hazard model and Cox-proportional hazards model, respectively. Results: Of the 96.3% (n = 876) patients who were R0 by Union for International Cancer Control (UICC) criteria, 34.5% (n = 3O2) remained R0 by IASLC criteria and 37.6% (n = 329) and 28% (n = 245) migrated to R(un) and R1, respectively. Most of the migration from UICC-R0 to lASLC-R(un) and IASLC-R1/R2 occurred due to inadequate nodal assessment (85.5%) and extracapsular nodal extension (77.6%), respectively. Compared to R0, the adjusted hazard ratios in R(un) and R1/R2 were 1.20 (95% confidence interval, 0.94-1.52), 1.50 (1.17-1.52) (P fortrend =.001) for recurrence and 1.18 (0.93-1.51) and 1.51 (1.17-1.96) for death (P for trend =.002). Conclusions: The IASLC R classification has prognostic relevance in patients with stage III-N2 NSCLC undergoing nCCRT followed by surgery. The IASLC classification will improve the thoroughness of intraoperative nodal assessment and the completeness of resection. © 2023 Lippincott Williams and Wilkins. All rights reserved.
- DOI
- 10.1097/SLA.0000000000005414
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
- Files in This Item:
There are no files associated with this item.
- Export
- RIS (EndNote)
- XLS (Excel)
- XML