RT Journal Article
SR Electronic
T1 Survival Outcomes in Patients With Locally Advanced NSCLC Converted to Resectable Disease by Neoadjuvant Therapy
JF In Vivo
JO In Vivo
FD International Institute of Anticancer Research
SP 522
OP 531
DO 10.21873/invivo.14216
VO 40
IS 1
A1 GULSEN, ECE DUYGU
A1 ISMAYILOV, RASHAD
A1 FARZALIYEVA, AYDAN
A1 RAMAZANOGLU, MEHMET NEZIR
A1 OGUZ, ARZU
A1 KILIC, DALOKAY
A1 AKCALI, ZAFER
A1 ALTUNDAG, OZDEN
YR 2026
UL http://iv.iiarjournals.org/content/40/1/522.abstract
AB Background/Aim: Neoadjuvant therapy enables disease conversion to resectability in selected patients with locally advanced non-small-cell lung cancer (NSCLC) but real-world survival outcomes in this setting are not well defined. This study aimed to evaluate survival outcomes and prognostic factors in patients with initially unresectable, non-metastatic NSCLC in whom complete resection was achieved following neoadjuvant therapy.Patients and Methods: This retrospective cohort study included 35 pa tients with initially unresectable NSCLC who underwent R0 resection after neoadjuvant therapy. Demographic, clinical, radiological, and pathological characteristics, treatment details, and survival outcomes were collected. Factors associated with event-free (EFS) and overall (OS) survival were analyzed.Results: The mean age at diagnosis was 67.6 years, and 85.7% of patients were male. Patients received a median of 3 (range=2-6) neoadjuvant therapy cycles (77% with carboplatin and paclitaxel). Postoperative pathology revealed mediastinal lymph node involvement in 37.1% and angiolymphatic invasion in 25.7% of patients. Adjuvant treatment was administered to 51.4% of patients, with no factor significantly associated with this decision. During a median follow-up of 40.6 months, the recurrence rate was 37.1%, and the mortality rate was 40%. The median EFS was 25.4 months, while the median OS was not reached. Two-year EFS and OS rates were 53.9% and 66.3%, respectively. Univariate analysis identified mediastinal lymph node involvement, angiolymphatic invasion, and receiving ≥3 neoadjuvant cycles as significant predictors of shorter EFS, while only mediastinal lymph node involvement significantly affected OS. Multivariate analysis did not reveal independent predictors, likely due to collinearity.Conclusion: Complete resection after neoadjuvant therapy yields favorable long-term survival in selected patients with initially unresectable NSCLC. Postoperative mediastinal lymph node status remains a critical prognostic factor.