WCLC 2025 - Posters & ePosters-P2.08 .36 Survival Outcomes in Locally Advanced NSCLC Patients Converted to Resectable Disease by Neoadjuvant Therapy

P2.08 .36 Survival Outcomes in Locally Advanced NSCLC Patients Converted to Resectable Disease by Neoadjuvant Therapy

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This retrospective study from Baskent University evaluated survival outcomes in 35 patients with initially unresectable locally advanced non-small cell lung cancer (NSCLC) who underwent complete resection (R0) after neoadjuvant therapy between 2003 and 2023. Patients were mainly male (86%), average age 67.6 years, with disease stages ranging from IIB to IIIC; histology was primarily squamous cell carcinoma (80%).<br /><br />Patients received a median of three neoadjuvant therapy cycles, mostly carboplatin and paclitaxel. Postoperative pathology showed mediastinal lymph node involvement in 37%, pleural invasion in 34.3%, and angiolymphatic invasion in 25.7%. About half received adjuvant therapy. Over a median follow-up of 40.6 months, 37.1% experienced recurrence and 40% died. The 2-year event-free survival (EFS) and overall survival (OS) rates were 54% and 66%, respectively; median EFS was 25.4 months, while median OS was not reached.<br /><br />Univariate analysis identified that mediastinal lymph node involvement, angiolymphatic invasion, and having 3 cycles of neoadjuvant therapy were significantly associated with shorter EFS. Mediastinal lymph node involvement was the only factor significantly linked with increased mortality risk. Angiolymphatic invasion and cycle number showed trends but did not reach significance for OS.<br /><br />The study concludes that complete surgical resection following neoadjuvant therapy offers favorable long-term survival in selected patients with initially unresectable locally advanced NSCLC. Postoperative mediastinal node status remains a critical prognostic marker. Future research should optimize neoadjuvant regimens, improve predictive markers for conversion to resectability and pathological response, and standardize surgical and pathological evaluation to better select candidates for this multimodal approach.

Asset Subtitle

Ozden Altundag

Meta Tag

Speaker Ozden Altundag

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

non-small cell lung cancer

NSCLC

neoadjuvant therapy

complete resection

mediastinal lymph node involvement

angiolymphatic invasion

event-free survival

overall survival

locally advanced lung cancer

Baskent University study