Optimal Timing of Surgical Resection for NSCLC
Posted: Friday, February 22, 2019
Delaying surgical resection after neoadjuvant therapy for patients with stage IIIa non–small cell lung cancer (NSCLC) does not seem to be associated with increased early mortality, according to findings presented at the 2019 Society of Thoracic Surgeons (STS)Annual Meeting in San Diego. Jonathan D. Rice, MD, PhD, of the University of Louisville, and colleagues, observed that delays were associated with worse 3-year postresection survival.
Researchers used data from the National Cancer Database to locate patients with clinical and pathologic stage IIIa NSCLC. They identified 5,946 patients who underwent surgical intervention and divided them into 3 groups based on the timing after neoadjuvant therapy: short delays (less than 77 days), mid delays (77–144 days), and long delays (more than 114 days). Preoperatively, 3,593 patients underwent chemoradiotherapy, 2,185 underwent chemotherapy alone, and 168 received radiation alone.
Among the cohorts, 1-year survival rates for short, mid, and long delays were 82%, 83%, and 80% respectively, whereas 3-year survival rates were 59%, 58%, and 52%, respectively. Postoperative lengths of stay, rates of 30-day readmission, as well as 30- and 90-day mortality rates were similar across all delay groups. A significant difference was observed for survival when patients received chemoradiotherapy compared with chemotherapy alone (hazard ratio = 0.994 vs. 1.608, respectively).
Disclosure: The study authors’ disclosure information may be found at www.sts.org.