Perioperative Predictive Factors for Tumor Regression and Survival in Non-Small Cell Lung Cancer Patients Undergoing Neoadjuvant Treatment and Lung Resection
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Data Assessments/Sources
2.3. Outcomes
2.4. Data Analysis
3. Results
3.1. Study Population
3.2. Logistic Regression Analysis of Risk Factors
3.3. Survival Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Patient Demographics at Study Entry | LUAD n = 58 | SQCA n = 37 | p-Value |
---|---|---|---|
Age (median, quartiles [1st; 3rd]) years | 60.73 [54.5; 69.0] | 65.6 [60.5; 70.3] | 0.0687 |
Age > 70 (n, %) | 11/58 (19.0%) | 10/37 (27.0%) | 0.3558 |
Sex (n, %) | 0.0009 | ||
Female | 27/58 (46.6%) | 5/37 (13.5%) | |
Male | 31/58 (53.4%) | 32/37 (86.5%) | |
BMI (median, quartiles [1st; 3rd]) | 25.3 [23.0; 27.2] | 23.8 [21.8; 26.6] | 0.1842 |
BMI > 18.5, <25 kg/m2 (n, %) | 25/58 (43.1%) | 24/37 (64.9%) | 0.0385 |
BMI > 25, <30 kg/m2 (n, %) | 29/58 (50.0%) | 10/37 (27.0%) | 0.0264 |
Pack years (median, quartiles [1st; 3rd]) | 30.0 [4.25; 45.0] PY | 40.0 [22.5; 52.5] PY | 0.0288 |
Never smokers (n, %) | 10/58 (17.2%) | 3/37 (8.1%) | 0.2066 |
Current smokers (n, %) | 32/58 (55.2%) | 18/37 (48.6%) | 0.5346 |
Ex-smokers (n, %) | 16/58 (27.6%) | 16/37 (43.2%) | 0.1143 |
Comorbidities (n, %) | |||
Respiratory | 21/58 (36.2%) | 18/37 (48.6%) | 0.4546 |
Cardiovascular | 9/58 (15.5%) | 2/37 (5.4%) | 0.1331 |
Renal | 2/58 (3.4%) | 3/37 (8.1%) | 0.3744 |
Liver | 3/57 (5.3%) | 3/37 (8.1%) | 0.6769 |
Neurological/psychiatric | 8/58 (13.8%) | 3/37 (8.1%) | 0.3984 |
Diabetes mellitus | 5/58 (8.6%) | 7/37 (18.9%) | 0.1407 |
Non-pulmonary malignancies | 12/58 (20.7%) | 4/37 (10.8%) | 0.2096 |
Lung function parameters (median, quartiles [1st; 3rd]) | |||
FVC (predicted, %) | 82.50 [72.75–98.00] | 79.00 [71.50–91.00] | 0.2903 |
FEV1 (predicted, %) | 80.50 [67.00–90.25] | 69.00 [55.50–85.00] | 0.0103 |
DLCO (predicted, %) | 62.50 [50.50–70.50] | 48.00 [42.00–62.00] | 0.0023 |
FEV1/FVC (%) | 95.00 [87.00–102.00] | 88.00 [78.00–95.00] | 0.0014 |
Tumor Characteristics | LUAD n = 58 | SQCA n = 37 | p-Value |
---|---|---|---|
Tumor side (n, %) | |||
Left | 27/58 (46.6%) | 16/37 (43.2%) | 0.7521 |
Right | 31/58 (53.4%) | 21/37 (56.8%) | |
TNM8 classification (n, %) | |||
cT1 | 11/58 (19.0%) | 0/37 (0%) | 0.0048 |
cT2 | 10/58 (17.2%) | 4/37 (10.8%) | 0.3886 |
cT3 | 14/58 (24.1%) | 9/37 (24.3%) | 0.9830 |
cT4 | 23/58 (39.7%) | 24/37 (64.9%) | 0.0166 |
Lymph node involvement (n, %) | |||
cN0 | 9/58 (15.5%) | 4/37 (10.8%) | 0.5151 |
cN1 | 11/58 (19.0%) | 7/37 (18.9%) | 0.9955 |
cN2 | 35/58 (60.3%) | 22/37 (59.5%) | 0.9315 |
cN3 | 3/58 (5.2%) | 4/37 (10.8%) | 0.3050 |
Features of the Surgical Procedures | LUAD n = 58 | SQCA n = 37 | p-Value |
---|---|---|---|
Surgical approach (n, %) | |||
Open (thoracotomy) | 50/58 (86.2%) | 35/37 (94.6%) | 0.1939 |
Minimally invasive (VATS) | 5/58 (8.6%) | 2/37 (5.4%) | 0.7017 |
Conversion to open | 3/58 (5.2%) | 0/37 (0.0%) | 0.2791 |
Resection extent (n, %) | |||
Lobectomy | 50/58 (86.2%) | 25/37 (67.6%) | 0.0298 |
Bilobectomy | 4/58 (6.9%) | 4/37 (10.8%) | 0.7071 |
Pneumonectomy | 4/58 (6.9%) | 8/37 (21.6%) | 0.0351 |
Neoadjuvant therapy | |||
Chemotherapy | 14/58 (24.1%) | 4/37 (10.8%) | 0.1060 |
Chemo- and immunotherapy | 5/58 (8.6%) | 2/37 (5.4%) | 0.7017 |
Radiation therapy | 0/58 (0.0%) | 1/37 (2.7%) | 0.3895 |
Chemo- and radiation therapy | 34/58 (58.6%) | 30/37 (81.1%) | 0.0228 |
Chemo-, immuno-, and radiation therapy | 5/58 (8.6%) | 0/37 (0.0%) | 0.1527 |
Adjuvant therapy | |||
Chemotherapy | 1/57 (1.8%) | 0/36 (0.0%) | 1.0000 |
Immunotherapy | 9/57 (15.8%) | 0/36 (0.0%) | 0.0121 |
Chemo- and immunotherapy | 0/57 (0.0%) | 1/36 (2.8%) | 0.3871 |
Radiation therapy | 8/57 (14.0%) | 1/36 (2.8%) | 0.0737 |
Chemo-, immune-, and radiation therapy | 1/57 (1.8%) | 1/36 (2.8%) | 1.0000 |
Primary tumor relapse or metastasis (n, %) | 31/57 (54.4%) | 8/36 (22.2%) | 0.0022 |
Mortality (n, %) | |||
During maximal follow-up | 25/58 (43.1%) | 21/37 (56.8%) | 0.5041 |
Overall survival (estimate [lower bound; upper bound], months) | 55.00 [17.06; 92.94] | 71.00 [44.89; 97.11] | 0.5041 |
Characterization of Tumor Regression Score | LUAD n = 58 | SQCA n = 37 | p-Value |
---|---|---|---|
TNM8 classification (n, %) | |||
yT0 | 10/58 (17.2%) | 22/37 (59.5%) | <0.0001 |
yT1 | 20/58 (34.5%) | 10/37 (27.0%) | 0.4459 |
yT2 | 11/58 (19.0%) | 2/37 (5.4%) | 0.0608 |
yT3 | 9/58 (15.5%) | 2/37 (5.4%) | 0.1331 |
yT4 | 8/58 (13.8%) | 1/37 (2.7%) | 0.0719 |
Lymph node involvement (n, %) | |||
yN0 | 34/58 (58.6%) | 33/37 (89.2%) | 0.0014 |
yN1 | 6/58 (10.3%) | 4/37 (10.8%) | 0.9425 |
yN2 | 17/58 (29.3%) | 0/37 (0.0%) | 0.0003 |
yN3 | 1/58 (1.7%) | 0/37 (0.0%) | 1.0000 |
Tumor regression grade (n, %) | |||
TRG_I (>95% vital tumor cells) | 6/58 (10.3%) | 3/37 (8.1%) | 0.7166 |
TRG_IIa (>10% vital tumor cells) | 27/58 (46.6%) | 5/37 (13.5%) | 0.0009 |
TRG_IIb (<10% vital tumor cells) | 15/58 (25.9%) | 9/37 (24.3%) | 0.8664 |
TRG_III (CPR, no vital tumor cells) | 10/58 (17.2%) | 20/37 (54.1%) | 0.0002 |
Tumor size in CT (median, quartiles [1st; 3rd]) (cm) | |||
Before neoadjuvant treatment | 3.95 [2.40; 6.68] | 5.50 [3.60; 6.35] | 0.2105 |
After neoadjuvant treatment | 2.55 [1.50; 4.60] | 3.30 [1.85; 4.35] | 0.3758 |
Absolute delta value | 1.15 [0.55; 2.50] | 1.70 [0.60; 3.10] | 0.4248 |
Relative delta value | 30.73 [14.95; 53.55] | 32.14 [14.17; 51.05] | 0.8397 |
Lymph node size in CT (median, quartiles [1st; 3rd]) (cm) | |||
Before neoadjuvant treatment | 1.60 [1.20; 2.03] | 1.60 [1.00; 2.20] | 0.9299 |
Covariates for Tumor Regression | Exp(B) [95% CI] | p-Value |
---|---|---|
Intraoperative histology (LUAD vs SQCA) | 6.88 [2.40–19.77] | 0.0003 |
Lymph node size in pre-neoadjuvant PET > 1.7 cm | 3.13 [1.11–8.83] | 0.0310 |
Absolute delta value > 2.6 cm | 3.76 [1.20–11.81] | 0.0233 |
Independent Predictors of Overall Survival | Exp(B) [95% CI] | p-Value |
---|---|---|
Age (>70 years) | 2.70 [1.37–5.36] | 0.0043 |
Extended resections (>one lobe) | 2.11 [1.10–4.08] | 0.0257 |
Absolute delta value > 2.6 cm | 3.82 [1.33–10.92] | 0.0126 |
Tumor recurrence or metastasis | 2.41 [1.27–4.54] | 0.0068 |
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Damirov, F.; Stoleriu, M.G.; Manapov, F.; Boedeker, E.; Dreher, S.; Gerz, S.; Hehr, T.; Sandner, E.; Ott, G.; Hatz, R.A.; et al. Perioperative Predictive Factors for Tumor Regression and Survival in Non-Small Cell Lung Cancer Patients Undergoing Neoadjuvant Treatment and Lung Resection. Cancers 2024, 16, 2885. https://doi.org/10.3390/cancers16162885
Damirov F, Stoleriu MG, Manapov F, Boedeker E, Dreher S, Gerz S, Hehr T, Sandner E, Ott G, Hatz RA, et al. Perioperative Predictive Factors for Tumor Regression and Survival in Non-Small Cell Lung Cancer Patients Undergoing Neoadjuvant Treatment and Lung Resection. Cancers. 2024; 16(16):2885. https://doi.org/10.3390/cancers16162885
Chicago/Turabian StyleDamirov, Fuad, Mircea Gabriel Stoleriu, Farkhad Manapov, Enole Boedeker, Sascha Dreher, Sibylle Gerz, Thomas Hehr, Evelin Sandner, German Ott, Rudolf Alexander Hatz, and et al. 2024. "Perioperative Predictive Factors for Tumor Regression and Survival in Non-Small Cell Lung Cancer Patients Undergoing Neoadjuvant Treatment and Lung Resection" Cancers 16, no. 16: 2885. https://doi.org/10.3390/cancers16162885
APA StyleDamirov, F., Stoleriu, M. G., Manapov, F., Boedeker, E., Dreher, S., Gerz, S., Hehr, T., Sandner, E., Ott, G., Hatz, R. A., & Preissler, G. (2024). Perioperative Predictive Factors for Tumor Regression and Survival in Non-Small Cell Lung Cancer Patients Undergoing Neoadjuvant Treatment and Lung Resection. Cancers, 16(16), 2885. https://doi.org/10.3390/cancers16162885