Patients with stage IIIA non-small cell lung cancer (NSCLC) who undergo surgery later than 6 weeks after neoadjuvant chemoradiation (NCRT) may experience significantly lower overall survival, according to results from a study published in the Journal of Thoracic Surgery.
Patients who present with locally advanced NSCLC at the time of diagnosis pose a significant clinical challenge to providers as very few survive 5 years. NCRT followed by surgery is the current standard of care for locally advanced patients; however the use of NCRT has not demonstrated a significant advantage over definitive chemoradiation therapy and the optimal interval to surgery after the completion of NCRT has not been clearly defined.
In a study led by researchers examined how the interval between NCRT and surgical resection impacted overall survival in 1623 patients with stage IIIA NSCLC diagnosed between 2004 and 2012. Patients were identified using the National Cancer Data Base.
Overall, 7.9% of patients underwent surgery at 0-3 weeks, 50.5% underwent surgery and 3-6 weeks, 31.9% underwent surgery at 6-9 weeks, and 9.6% underwent surgery at 9-12 weeks. Researchers found that there was no significant difference in survival among the patients who underwent surgery at 0-3 weeks or 3-6 weeks, but that there was decreasing overall survival in the other groups. Median overall survival in the 6-9 week group was 44.1 months and fll to 36.1 months in those treated at 9-12 weeks.
“The results of this study demonstrate that a significant correlation may exist between [overall survival] and [interval to surgery], and that delaying surgery beyond 6 weeks after NCRT may negatively impact survival,” authors of the study concluded.
They added that further prospective studies are need to confirm these findings and determine the reasons for the existence of this correlation.
