Dataset Information

Predictors of relapse and evaluation of the role of postoperative radiation therapy in a modern series of patients with surgically resected stage III (N2) non-small cell lung cancer.

ABSTRACT: PURPOSE:For patients with stage III (N2) non-small cell lung cancer (NSCLC) treated with surgical resection, postoperative chemotherapy improves overall survival (OS), but the role of postoperative radiation therapy (PORT) is controversial. The purpose of this study was to evaluate risk factors for local-regional recurrence and to evaluate the impact of PORT on local-regional control (LRC) and OS in a modern series of patients with surgically resected stage III (N2) NSCLC. METHODS AND MATERIALS:A retrospective review was performed of patients with Stage III (N2) NSCLC who underwent curative intent resection at our institution between February 1999 and January 2012. OS, LRC, and metastasis-free survival were estimated from the date of surgery using the Kaplan Meier method. RESULTS:A total of 71 patients were included in the study. Patient median age was 63 years. Histology was adenocarcinoma in 69% of patients. Pretreatment positron emission tomography/computed tomography staging was performed for 90% of patients, and preoperative chemotherapy was administered in 23%. The rate of R0 resection was 96%. Forty-one patients (58%) received PORT and the median PORT dose was 50 Gy (range, 41.4-60 Gy). The median follow-up time for living patients was 5.0 years. Five-year OS for all patients was 66%. OS at 5 years for patients who received PORT compared with patients who did not receive PORT was 71% versus 60%, respectively (hazard ratio [HR], 0.61; 95% CI, 0.30-1.44; P = .28). LRC at 5 years for patients who received PORT compared with patients who did not receive PORT was 89% versus 76%, respectively (HR, 0.44; 95% CI, 0.13-1.45; P = .17). Factors associated with decreased LRC were male sex (P = .011) and primary tumor (pT) stage (pT3/4 vs. pT1/2, P = .006). Metastasis-free survival at 5 years for patients who received PORT compared with those who did not receive PORT was 62% versus 63%, respectively (HR, 1.07; 95% CI, 0.51-2.40; P = .86). CONCLUSIONS:In this modern series of patients with resected stage III (N2) NSCLC, patients who received PORT had higher rates of OS and LRC, but these differences were not statistically significant.

SUBMITTER: Breen WG

PROVIDER: S-EPMC5514239 | biostudies-literature | 2017 Jan-Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Predictors of relapse and evaluation of the role of postoperative radiation therapy in a modern series of patients with surgically resected stage III (N2) non-small cell lung cancer.

Breen William G WG Merrell Kenneth W KW Mansfield Aaron S AS Wigle Dennis A DA Garces Yolanda I YI Park Sean S SS Olivier Kenneth R KR Hallemeier Christopher L CL

Advances in radiation oncology 20161221 1

<h4>Purpose</h4>For patients with stage III (N2) non-small cell lung cancer (NSCLC) treated with surgical resection, postoperative chemotherapy improves overall survival (OS), but the role of postoperative radiation therapy (PORT) is controversial. The purpose of this study was to evaluate risk factors for local-regional recurrence and to evaluate the impact of PORT on local-regional control (LRC) and OS in a modern series of patients with surgically resected stage III (N2) NSCLC.<h4>Methods and ...[more]

PMID: 28740911

Similar Datasets

Project description:Simple Summary This multicenter retrospective study aimed to describe the outcomes of patients with endometrial cancer after central pelvic/vaginal relapse treated with radical radiotherapy (RT). We included 139 patients with a median follow-up time of 6.66 years. Patients were treated with external beam radiotherapy to elective pelvic lymph-node regions and boost to the pelvic tumor. During follow-up, 55 (39.6%) patients developed a second relapse, the majority (75%) with disease sites outside the radiation field. Risk group at primary diagnosis and type of boost administration were independent predictors of progression-free and overall survival. Five-year overall survival for the whole cohort was 68% (95% CI: 59–75%). The majority of isolated pelvic recurrences in RT-naive women with EC can be successfully salvaged by RT but survival in high-risk patients remains suboptimal. Individualizing of adjuvant treatment in first line and better treatment alternatives at relapse are important to ultimately improve survival. Abstract (1) Background: This study evaluated the clinical outcome after salvage radiotherapy for first pelvic relapse after endometrial cancer (EC). (2) Methods: This multicenter retrospective study included EC patients with first central pelvic relapse without lymph node involvement treated with curative intent. Progression-free (PFS) and overall survival (OS) were calculated with the Kaplan–Meier method and possible predictive factors for risk of relapse and mortality were identified using the Cox model. (3) Results: We included 139 patients with median EQD2 (Equivalent Dose in 2 Gy fractions) to the clinical target volume of 70.0 Gy. During follow up of median 6.66 years, 39.6% patients developed a second relapse. Risk group classification at primary diagnosis based on histology, grading and FIGO stage and how the pelvic tumor boost was administered were independently associated with PFS and OS. Five-year OS was 68% (95% CI (59–75)) for the whole cohort. Five-year OS was 88% (95% CI (75–94)), 72% (95% CI (55–84)) and 38% (95% CI (15–60)) for the stage I low-, intermediate- and high-risk group, respectively. (4) Conclusions: The majority of central pelvic recurrences in RT-naive EC women can be successfully salvaged with radiotherapy. However, survival in patients with high-risk disease remains poor and warrants a more individualized approach to optimize outcome.

Project description:BackgroundLung cancer serum tumor markers including carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), and carbohydrate antigen 125(CA125) as prognostic predictors is controversial. Therefore, this study aimed to evaluate the association between these markers and the survival of patients with postoperative stage III-N2 non-small cell lung cancer (NSCLC).MethodsWe enrolled 1011 patients with pathologically confirmed stage III-N2 NSCLC who underwent resection and whose pretreatment serum tumor marker levels were available. Patients were categorized according to their serum levels into low-, medium-, and high-risk groups. Overall survival (OS), progression-free survival (PFS), local regional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were calculated from the date of resection. Their association with each serum tumor marker was assessed using the log-rank test.ResultsAbnormal CEA levels were associated with worse five-year OS, PFS and DMFS; abnormal CYFRA21-1 levels were associated with worse five-year OS and LRFS; and abnormal CA125 levels were associated with worse five-year OS, PFS, LRFS and DMFS. Among the risk groups, there were significant differences in five-year OS, PFS, LRFS and DMFS (P = 0.000). In propensity score matching analysis, the model also achieved prognostic significance for all four survival classifications (P = 0.001-0.004) among the three risk groups.ConclusionsThe combined model achieved prognostic significance for all survival outcome types. The serum tumor markers tested are useful prognostic predictors for postoperative NSCLC patients but not for all survival outcomes. The combination of the three indices is more reliable in predicting all four of the survival outcomes.Key pointsSIGNIFICANT FINDINGS OF THE STUDY: Serum CEA, CYFRA21-1, and CA125 levels can be used as prognostic factors of postoperative N2 non-small cell lung cancer patients but not for all survival outcomes, suggesting that combinative detection of all three indices would be more reliable.What this study addsOur model utilizes available technology, with conventional cutoff values, inexpensive costs, and simple mathematics methods and, thus, can be feasibly employed by clinicians or oncologists.

Dataset Information

Predictors of relapse and evaluation of the role of postoperative radiation therapy in a modern series of patients with surgically resected stage III (N2) non-small cell lung cancer.

Publications

Predictors of relapse and evaluation of the role of postoperative radiation therapy in a modern series of patients with surgically resected stage III (N2) non-small cell lung cancer.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets