Definition of resectable stage III non-small cell lung cancer (NSCLC) for inclusion in clinical trials: A clinical case review by a pan-European multidisciplinary expert panel led by the EORTC Lung Cancer Group.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Brandão Mariana, Prisciandaro Elena, Xenophontos Eleni, Mariolo Alessio, Sadeghi Amir H, Filippi Andrea R, Levy Antonin, Bandura Artur, Caramella Caroline, Dickhoff Chris, de Margerie-Mellon Constance, Faivre-Finn Corinne, Portik Daniel, Sanchez-Lorente David, De Ruysscher Dirk, Smit Egbert, Gobbini Elisa, Fadel Elie, Ruffini Enrico, Olmetto Emanuela, Cortiula Francesco, Bahce Idris, Houda Ilias, Opitz Isabelle, Naidoo Jarushka, Edwards John, Remon Jordi, Benitez José Carlos, Trujillo Juan Carlos, Derks Jules, Amrane Karim, Hartemink Koen J, Stathopoulos Konstantinos, Hendriks Lizza E L, Iglesias Manoli, Occhipinti Mario, Guckenberger Matthias, Giaj Levra Niccolo, Girard Nicolas, Reguart Noemi, Mercier Olaf, Bironzo Paolo, Hofman Paul, Petersen René Horsleben, De Angelis Riccardo, Abgral Ronan, Terrisse Safae, Popat Sanjay, Pierret Thomas, Blum Torsten Gerriet, Ricardi Umberto, Dionisi Valeria, Berghmans Thierry, Dingemans Anne-Marie C, European Organisation for Research, Treatment of Cancer EORTC Lung Cancer Group
Аннотация
METHODS: Consecutive patients with clinical stage III NSCLC (8th TNM edition) treated at Institut Jules Bordet between 2016-2021 were identified. These cases underwent evaluation by multidisciplinary panels (MDT), comprising thoracic surgeons, radiation oncologists, medical oncologists/pulmonologists and imaging specialists. The MDT determined the resectability of each tumor, and non-consensual cases underwent a second and a third discussion rounds. A TNM-subset was classified as "resectable" if ≥75 % of cases within that category were deemed "resectable" following multiple rounds of review.
RESULTS: Among 105 cases, 52 % of tumors were stage IIIA, 36 % stage IIIB and 11 % stage IIIC. After the first two review rounds, 13 % of cases were classified as "no consensus" and moved to a third round. The main reasons were suboptimal imaging (n = 8), incomplete invasive mediastinal staging to assess the N factor (n = 3), and disagreement on the resectability of T4 tumors invading thoracic structures or with multi-station/bulky N2 disease (n = 3). After the third review round, T3-T4 tumors based on size/satellite nodules and/or with N1-N2 single-station involvement were considered resectable. In contrast, many invasive T4-tumors were considered unresectable, especially if combined with N2-N3 disease. N2-multi-station, N2-bulky or N3 involvement were generally considered unresectable (100 %/95 %/95 % respectively).
CONCLUSIONS: After a multiple-round multidisciplinary review of real-world cases, consensus was reached for most TNM-subsets, except for invasive T4N0 tumors. This case review informed the Consensual Definition of Resectable stage III NSCLC in clinical trials.