Pathologic Assessment After Neoadjuvant Chemotherapy for NSCLC: Importance and Implications of Distinguishing Adenocarcinoma From Squamous Cell Carcinoma
Pathologic Assessment After Neoadjuvant Chemotherapy for NSCLC: Importance and Implications of Distinguishing Adenocarcinoma From Squamous Cell Carcinoma
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DOI：
10.1016/j.jtho.2018.11.017
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发表时间：
2019-03-01
影响因子：
20.4
通讯作者：
Travis, William D.
中科院分区：
文献类型：
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作者：
Qu, Yang;Emoto, Katsura;Travis, William D.
前言：非小细胞肺癌新辅助化疗(NAC)后的主要病理反应被定义为未区分组织学类型的10%或以下的残留存活肿瘤。我们试图研究肺腺癌(ADC)和鳞癌(SCC)之间预测生存的最佳残存肿瘤截止率是否不同。方法：回顾272例接受NAC治疗和临床II-III期非小细胞肺癌(ADC，n=192；SCC，n=80)患者的肿瘤切片。使用最大选择等级统计量确定预测肺癌特异性累积死亡发生率(LC-CID)的最佳存活肿瘤截断率。LC-CID采用竞争风险方法进行分析。采用Kaplan-Meier方法和Cox比例风险分析评估总体生存率。结果：鳞癌患者对NAC有更好的疗效(存活肿瘤的中位数百分比：SCC和ADC40%和60%；p=0.027)。主要病理反应(
Introduction: Major pathologic response after neoadjuvant chemotherapy (NAC) for NSCLC has been defined as 10% or less residual viable tumor without distinguishing between histologic types. We sought to investigate whether the optimal cutoff percentage of residual viable tumor for predicting survival differs between lung adenocarcinoma (ADC) and squamous cell carcinoma (SCC).Methods: Tumor slides from 272 patients treated with NAC and surgery for clinical stage II-III NSCLC (ADC, n = 192; SCC, n = 80) were reviewed. The optimal cutoff percentage of viable tumor forpredicting lung cancer-specific cumulative incidence of death (LC-CID) was determined using maximally selected rank statistics. LC-CID was analyzed using a competing-risks approach. Overall survival was evaluated using Kaplan-Meier methods and Cox proportional hazard analysis.Results: Patients with SCC had a better response to NAC (median percentage of viable tumor: SCC versus ADC, 40% versus 60%; p = 0.027). Major pathologic response (