Results of surgery after neoadjuvant treatment for non-small cell lung cancer

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dc.contributor.authorYagci, Tarik
dc.contributor.authorUcvet, Ahmet
dc.contributor.authorYazgan, Serkan
dc.contributor.authorSamancilar, Ozgur
dc.contributor.authorGürsoy, Soner
dc.date.accessioned2025-03-20T09:41:26Z
dc.date.available2025-03-20T09:41:26Z
dc.date.issued2024
dc.departmentİzmir Bakırçay Üniversitesi
dc.description.abstractBackground: In locally advanced non-small cell lung cancer, survival rates achieved only by surgical treatment are unfortunately lower than expected. It’s believed that survival rates can be raised by multimodal therapies including surgery. The purpose of the study is to analyse the results of surgical treatment in patients who underwent surgical resection after neoadjuvant treatment due to locally advanced non-small cell lung cancer. Materials and Methods: The patients who underwent lobectomy or pneumonectomy after neoadjuvant chemotherapy and/or radiotherapy due to locally advanced non-small cell lung cancer were included in this study. The patients were divided into two groups according to oncological treatment indication. Group A included patients who received neoadjuvant therapy due to T disease and group B due to N2 disease. The surgical interventions, pathological results, postoperative complications, mortality, recurrence, 5-year disease-free survival, and overall survival were analysed. Results: 154 patients were included in the study. 142 were men and 12 were women with a mean age of 57.7 ± 16.97 (between 35 and 77). Ninety-six patients received induction therapy due to T disease, and 58 patients due to N2 disease. Pneumonectomy was performed on 41 patients, lobectomy was performed on 113 patients (18 bronchial sleeve resection). Histopathologic results revealed squamous cell carcinoma in 96 (62.3%), adenocarcinoma in 52 (33.8) and large cell carcinoma in 6 (3.9%) patients. A complete response to neoadjuvant treatment was achieved in 19 (Group A, n = 15, group B, n = 4) patients. Postoperative pathologic results showed mediastinal lymph node metastasis in 13 (13.6%) patients in group A and, in 28 (48.3%) patients in group B, which is statistically significant. Prolonged air leak was the most common complication in both groups. Operative mortality was observed in 4 (2.6%) patients. In 82 patients 47 in group A and 35 in group B recurrence or metastasis were detected during the follow-up. 5-year disease-free survival rate was 43.2% in group A and 38.4% in group B. Five- year survival rate was 46.1% in group A and 38% in group B. Conclusions: The patients who achieved a histopathologic complete response following induction therapy had statistically significantly better disease-free and overall survival rates. Pathologically proven lymph node metastasis increased the rate of recurrence or metastasis significantly (p = 0.01). The disease-free and overall survival rate decreased significantly (p = 0.0001, p = 0.0001). It is deducible in light of these findings that patients who received neoadjuvant treatment for N2 achieved better disease-free survival and overall survival.
dc.identifier.doi10.26663/cts.2024.007
dc.identifier.endpage46
dc.identifier.issn2548-0316
dc.identifier.issue1
dc.identifier.startpage38
dc.identifier.trdizinid1274855
dc.identifier.urihttps://doi.org/10.26663/cts.2024.007
dc.identifier.urihttps://search.trdizin.gov.tr/tr/yayin/detay/1274855
dc.identifier.urihttps://hdl.handle.net/20.500.14034/1967
dc.identifier.volume9
dc.indekslendigikaynakTR-Dizin
dc.language.isoen
dc.relation.ispartofCurrent Thoracic Surgery
dc.relation.publicationcategoryMakale - Ulusal Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_TR_20250319
dc.subjectLung cancer
dc.subjectlung resection
dc.subjectinduction therapy
dc.titleResults of surgery after neoadjuvant treatment for non-small cell lung cancer
dc.typeArticle

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