WCLC 2025 - Posters & ePosters-EP.07.34 A Study of Lung Cancer Patients Who Survived for More Than 5 Years After Incomplete Resection

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This retrospective study from the Sendai Medical Center in Japan analyzed clinical and pathological features of lung cancer patients who survived more than five years following incomplete surgical resection between 2000 and 2017. Among 94 patients with incomplete resection, 33 achieved long-term survival (over 5 years). The cohort included 1862 lung cancer cases, with 1764 undergoing complete resection and 98 incomplete. The study focused on incomplete resections due to reasons like pleural dissemination, malignant pleural effusion, residual lymph nodes, great vessel invasion, positive surgical margins, and positive pleural lavage cytology.<br /><br />Key findings showed that long-term survivors more frequently had undergone lobectomy or more extensive surgeries compared to others. While pathological stage and TNM factors did not differ significantly between groups, the long-term survivor group had higher, though not statistically significant, proportions of positive pleural lavage cytology, EGFR mutation positivity, and R1 (microscopic residual tumor) resections. Importantly, lobectomy or greater resection was associated with significantly improved survival in R1 cases but not in R2 (macroscopic residual tumor) cases.<br /><br />Postoperative treatment with tyrosine kinase inhibitors (TKIs), particularly in EGFR-mutated patients, was linked to better survival outcomes, reinforcing the impact of targeted systemic therapies on prognosis after incomplete resection. Conversely, platinum-based chemotherapy did not show a survival benefit.<br /><br />The study concludes that incomplete resection does not preclude long-term survival, especially when primary tumor removal is achieved and TKI therapies are applied. These improvements likely reflect advances in systemic treatments rather than changes in tumor biology indicated by pleural lavage cytology status. Thus, optimizing surgical extent and leveraging targeted therapies are critical for managing lung cancer patients with incomplete resection.

Asset Subtitle

Fumihiko Hoshi

Meta Tag

Speaker Fumihiko Hoshi

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

lung cancer

incomplete surgical resection

long-term survival

lobectomy

pleural dissemination

EGFR mutation

tyrosine kinase inhibitors

R1 resection

postoperative treatment

targeted therapy