Mediastinal downstaging after induction treatment is not a significant prognostic factor to select patients who would benefit from surgery: the clinical value of the lymph node ratio.
Fiche publication
Date publication
février 2015
Auteurs
Membres identifiés du Cancéropôle Est :
Pr FALCOZ Pierre-Emmanuel, Pr OLLAND Anne
Tous les auteurs :
Renaud S, Falcoz PE, Olland A, Reeb J, Santelmo N, Massard G
Lien Pubmed
Résumé
OBJECTIVES: Multimodal management of N2 non-small-cell lung cancer is still a matter of debate. In particular, the place of surgery for persistent N2 after induction treatment is controversial and surgery is usually reserved for patients experiencing a mediastinal downstaging (pN1 and pN0). We aimed to evaluate whether there might exist subgroups of pN2 according to the lymph node ratio (LNR). METHODS: Between 1996 and 2012, we retrospectively reviewed the data from 152 potentially resectable cN2 patients who underwent an induction treatment before surgery. RESULTS: The median follow-up time was 32 months (2-112). The average age at the time of diagnosis was 58.52 +/- 10.47 years. In univariate analysis, overall survival (OS) was significantly influenced by extracapsular spread (32 +/- 5.33 vs 24 +/- 12.73 months, P = 0.01), pN after surgery (65 +/- 2.45 months for pN0, 44 +/- 2.14 months for pN1 and 19 +/- 1.72 months for pN2, P /= 1/3 (30 +/- 3.77 months vs 16 +/- 1.39 months, P /= 1/3 (48 +/- 2.64 months vs 26 +/- 5.65 months, P
Référence
Interact Cardiovasc Thorac Surg. 2015 Feb;20(2):222-7