WCLC 2025 - Posters & ePosters-EP.07.50 Real-World Treatment Strategy and Postoperative Prognosis for Clinical Stage II/III NSCLC: A Multicenter Study

EP.07.50 Real-World Treatment Strategy and Postoperative Prognosis for Clinical Stage II/III NSCLC: A Multicenter Study

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This multicenter retrospective study analyzed treatment strategies and postoperative prognosis for 201 patients with clinical stage II/III non-small cell lung cancer (NSCLC) undergoing pulmonary resection between March 2022 and August 2024. Patients had a median age of 72; 68% were male, and most had good performance status (87% ECOG-PS 0). Clinical staging included 61% stage II and 39% stage III, with nodal involvement spanning cN0 (41%), cN1 (34%), and cN2 (25%).<br /><br />The majority (82%) underwent upfront surgery, while 18% received neoadjuvant therapy (11% chemoradiotherapy or chemotherapy; 7% immunochemotherapy). Following the approval of neoadjuvant immune checkpoint inhibitors (neoadjuvant ICI), use of neoadjuvant therapy increased notably in cN1 and cN2 patients—from 30% to 50% in cN2 cases. Adjuvant therapy included atezolizumab (12%) and osimertinib (6%).<br /><br />Survival analyses revealed no significant differences in recurrence-free survival or overall survival between clinical stages II and III, nor between nodal statuses cN0, cN1, and cN2. Additionally, treatment modality (surgery alone, surgery plus adjuvant therapy, neoadjuvant chemoradiation/chemotherapy, or neoadjuvant immunochemotherapy) did not significantly impact short-term survival outcomes.<br /><br />The study concludes that the introduction and increased use of neoadjuvant therapy, particularly immune checkpoint inhibitors, have led to a comparable short-term prognosis for patients with nodal involvement (cN1/N2) relative to those without (cN0). This suggests neoadjuvant regimens may mitigate the historically poorer prognosis of nodal disease. However, longer follow-up is necessary to evaluate long-term survival outcomes by treatment type in this real-world, perioperative personalized medicine setting.

Asset Subtitle

Taichi Matsubara

Meta Tag

Speaker Taichi Matsubara

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

non-small cell lung cancer

NSCLC

clinical stage II/III

pulmonary resection

neoadjuvant therapy

immune checkpoint inhibitors

atezolizumab

osimertinib

recurrence-free survival

perioperative personalized medicine