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General Thoracic and Cardiovascular Surgery

27-09-2024 | Lung Cancer | Original Article

Survival impact of pathologic features after salvage lung resection following definitive chemoradiotherapy or systemic therapy for initially unresectable lung cancer

Authors: Naoyuki Oka, Tomoyuki Hishida, Kaoru Kaseda, Yuri Suzuki, Yu Okubo, Kyohei Masai, Keisuke Asakura, Katsura Emoto, Hisao Asamura

Published in: General Thoracic and Cardiovascular Surgery

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Abstract

Purpose

Salvage surgery for primary lung cancer is expected to become increasingly common. This study aimed to clarify the survival impact of pathologic characteristics after salvage surgery.

Methods

Consecutive patients who underwent salvage surgery following definitive chemoradiotherapy or systemic therapy for initially unresectable lung cancer from 2010 to 2020 were enrolled in this study. The tumor slides were reviewed to determine the size of the tumor bed and the proportions of viable tumor, necrosis, and stroma.

Results

A total of 23 patients were evaluated, and 18 had clinical stage IIIB–IV disease. Six received chemoradiotherapy and 17 received systemic therapy alone. A major pathologic response (MPR, ≤ 10% of viable tumor) was observed in 6 patients, and 4 patients achieved a pathological complete response. The 3-year overall and recurrence-free survival rates (OS and RFS) were 78.6% and 59.2%, respectively. There was no significant difference in OS between patients with and without MPR, and even non-MPR patients achieved a favorable 3-year OS of 70.2%. Meanwhile, patients with high (≥ 30%) stroma showed significantly better OS than those with low (< 30%) stroma (3-year OS: 100% vs. 23.3%, p < 0.001).

Conclusions

This study showed that the proportion of stroma can be useful for predicting long-term survival after salvage surgery. Further large-scale studies are warranted to confirm the current findings.
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Metadata
Title
Survival impact of pathologic features after salvage lung resection following definitive chemoradiotherapy or systemic therapy for initially unresectable lung cancer
Authors
Naoyuki Oka
Tomoyuki Hishida
Kaoru Kaseda
Yuri Suzuki
Yu Okubo
Kyohei Masai
Keisuke Asakura
Katsura Emoto
Hisao Asamura
Publication date
27-09-2024
Publisher
Springer Nature Singapore
Published in
General Thoracic and Cardiovascular Surgery
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-024-02086-y
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