P-139WHICH VARIABLES BEST PREDICT OUTCOMES IN PATIENTS WITH STAGE II/III NON-SMALL-CELL LUNG CANCER AFTER NEOADJUVANT THERAPY?

• Published in: Interactive cardiovascular and thoracic surgery Vol. 18; no. suppl_1; p. S37
• Main Authors: Ozeki, Naoki, Kawaguchi, K., Taniguchi, T., Usami, N., Fukui, T., Ishiguro, F., Nakamura, S., Yokoi, K.
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01-06-2014
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivu167.139

Objectives: It is debatable which variables best predict outcomes in patients with non-small-cell lung cancer (NSCLC) after neoadjuvant therapy; evaluation by Response Evaluation Criteria In Solid Tumours (RECIST), tumour volume response and maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose positron emission tomography. This study was designed to elucidate the predictive usefulness of evaluation by RECIST, volume response and post-neoadjuvant SUVmax (ySUVmax).
Methods: Between December 2006 and June 2012, 33 patients who were diagnosed as clinical stage II/III NSCLC and underwent pulmonary resection following neoadjuvant therapy were enrolled in this study. Relationships between the variables and pathological complete response (pCR), disease-free survival (DFS) and overall survival (OS) were analyzed.
Results: The patients and tumour characteristics were as follows: mean tumour volume: 84.3 ml; cN0/cN1/cN2: n =20/3/10; mean SUVmax: 13.9; neoadjuvant therapy (chemoradiotherapy/chemotherapy/radiotherapy): n = 24/5/4; mean post-neoadjuvant tumour volume: 41.9 ml; voume response (50% reduction in tumour volume)/non-volume response: n = 21/12; ycN0/ycN1/ycN2: n = 23/5/5; mean ySUVmax: 5.5; evaluation by RECIST (PR/SD): n = 12/21; pCR/non-pCR: n = 8/25; ypN0/ypN1/ypN2: n = 26/5/2. The median follow-up period was 42 months. The 3-year DFS was 70%, and the 3-year OS was 78%. ySUVmax had significant relation to pCR (P = 0.0067), whereas volume response did not. pCR was found in 8% of the tumours with PR and in 33% of the tumours with SD. In the multivariate Cox regression analysis with a cut-off value of ySUVmax 7.5, both volume response and ySUVmax were significant factors for DFS (P = 0.0045, 0.0455). ySUVmax was a significant factor also for OS (P = 0.0307). Evaluation by RECIST was neither a significant factor for DFS nor for OS.
Conclusions: Volume response and ySUVmax following neoadjuvant therapy can be valid alternative parameters to predict survival for patients with stage II/III NSCLC.
Disclosure: No significant relationships.