Stage IIIa NSCLC: delaying surgery leads to worse OS

  • Rice JD & al.
  • Ann Thorac Surg
  • 19 Nov 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with stage IIIa NSCLC who underwent surgical resection within 77 days of neoadjuvant therapy have significantly better survival than those who delay.

Why this matters

  • There is no consensus on the timing of surgery after neoadjuvant therapy.

Study design

  • Patients with stage IIIa NSCLC received neoadjuvant therapy and then underwent surgical resection within 77 days (short delay; n=1558), within 77-114 days (mid delay; n=2950), or after >114 days (long delay; n=1438).
  • Funding: None disclosed.

Key results

  • The long delay group had larger median tumor size (45 vs 42 mm in short delay and 42 mm in mid delay; P=.0003).
  • Chemotherapy was more common in the long vs short and mid delay group (43% vs 30% and 37%; P<.0001 and chemoradiotherapy in the short vs mid long delay group p>
  • OS was significantly longer in the short vs mid and long delay group at 1 year (82% vs 83% and 80%; P=.003) and 3 years (59% vs 58% and 52%; P=.003).
  • A long delay between therapy and surgery was associated with higher mortality (HR, 1.25; P=.0005).
  • Postoperative length of stay, readmission rates, and mortality at 30 and 90 days were similar between groups.

Limitations

  • Retrospective study.