P2-190: The number of residual metastatic lymph nodes following neoadjuvant chemotherapy predicts survival in patients with stage III NSCLC

Background Neoadjuvant chemotherapy has been increasingly utilized in the treatment of breast cancer patients. However, there are no established surrogate markers predicting the response to subsequent adjuvant therapy and clinical outcome of patients. In particular, whether primary or lymph nodes metastasis should be evaluated for these analyses has remained unknown. Therefore, in this study, we first evaluated the differences in biomarkers between primary and metastatic cancer tissues in the patients undergoing neoadjuvant chemotherapy. We then correlated the findings with the clinical outcomes of these patients. Methods We examined 49 patients receiving neoadjuvant chemotherapy and subsequent surgery with lymph node metastasis. Estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2) and Ki-67 were all immunohistochemically evaluated in core needle biopsy samples from primary and metastatic tumors following chemotherapy. Results No statistically significant differences in these markers were detected between the primary tumor and metastatic lymph nodes following therapy, but the Ki-67 labeling index was significantly higher in metastatic lymph nodes than in primary tumor (p = 0.017). The patients associated with luminal A type carcinoma in their lymph nodes following chemotherapy demonstrated significantly better clinical outcomes (disease-free survival: p = 0.0045, overall survival: p = 0.0006) than those who were not. Conclusion These data indicate that subtype classification following chemotherapy, in the metastatic lymph nodes rather than primary tumor could predict long-term outcomes of patients undergoing neoadjuvant chemotherapy.

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Recruitment of Podoplanin Positive Cancer-Associated Fibroblasts in Metastatic Lymph Nodes Predicts Poor Prognosis in Pathological N2 Stage III Lung Adenocarcinoma

Annals of Surgical Oncology ◽

10.1245/s10434-012-2421-4 ◽

2012 ◽

Vol 19 (12) ◽

pp. 3953-3962 ◽

Cited By ~ 22

Author(s):

Shinya Neri ◽

Genichiro Ishii ◽

Tetsuhiko Taira ◽

Tomoyuki Hishida ◽

Junji Yoshida ◽

...

Keyword(s):

Lymph Nodes ◽

Lung Adenocarcinoma ◽

Poor Prognosis ◽

Stage Iii ◽

Cancer Associated Fibroblasts ◽

Metastatic Lymph Nodes ◽

Metastatic Lymph

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P1035 Different significance of the number of metastatic lymph nodes between primary surgical treatment and neoadjuvant chemotherapy followed by surgery in early-stage cervical cancer

International Journal of Gynecology & Obstetrics ◽

10.1016/s0020-7292(09)62521-2 ◽

2009 ◽

Vol 107 ◽

pp. S703-S703

Author(s):

H. Kim ◽

J. Kim ◽

H. Wu ◽

N. Park ◽

Y. Song ◽

...

Keyword(s):

Cervical Cancer ◽

Surgical Treatment ◽

Neoadjuvant Chemotherapy ◽

Lymph Nodes ◽

Early Stage ◽

Metastatic Lymph Nodes ◽

Metastatic Lymph ◽

Early Stage Cervical Cancer

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Proposal of new classification for stage III breast cancer on the number and ratio of metastatic lymph nodes

Journal of Surgical Oncology ◽

10.1002/jso.23118 ◽

2012 ◽

Vol 106 (6) ◽

pp. 696-702 ◽

Cited By ~ 6

Author(s):

Cong Zhu ◽

Xiong-Zhi Wu

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Stage Iii ◽

New Classification ◽

Metastatic Lymph Nodes ◽

Metastatic Lymph ◽

Stage Iii Breast Cancer

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RA07.09: THE EFFICACY OF ASSESSING METASTATIC LYMPH NODES BY COMPUTED TOMOGRAPHY IN ADVANCED ESOPHAGEAL CANCER WITH NEOADJUVANT CHEMOTHERAPY

Diseases of the Esophagus ◽

10.1093/dote/doy089.ra07.09 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 37-37

Author(s):

Shinya Urakawa ◽

Tomoki Makino ◽

Koji Tanaka ◽

Yasuhiro Miyazaki ◽

Tsuyoshi Takahashi ◽

...

Keyword(s):

Esophageal Cancer ◽

Neoadjuvant Chemotherapy ◽

Lymph Nodes ◽

Cancer Patients ◽

Reduction Rate ◽

Short Axis ◽

Advanced Esophageal Cancer ◽

Primary Tumors ◽

Metastatic Lymph Nodes ◽

Metastatic Lymph

Abstract Background Although various modalities including CT, endoscopy, and positron emission tomography (PET) have been used to predict pathological tumor response (pTR) to neoadjuvant chemotherapy (NACT) or prognosis in esophageal cancer patients, an optimal method of response evaluation remains to be established. Methods A total of 97 non-T4 thoracic esophageal cancer patients who underwent curative surgery after NACT from 2011 to 2014 with both measurable primary tumors (PT) and metastatic lymph nodes (LNs) by CT (≥ 10mm in short axis or ≥ 5mm in short axis with SUV-max ≥ 2.5) were analyzed. Patients with ≥ 50% decrease in size of the PT (two-direction measurement) and ≥ 30% decrease in size of LNs (sum of short diameter based on RECIST criteria) were defined as PT- and LNs-responders, respectively. Results The median reduction rate of PT and LNs were 62.0% (5.5–93.4) and 26.7% (60.9–13.6), respectively. Of 97 patients, 62 (69%) and 45 patients (45%) were classified as PT- and LNs-responders respectively. The concordance rate between CT response of PT and LNs was 66% (P = 0.01). CT response of PT was correlated with pTR (P<0.0001) while CT response of LNs was associated with pT (P = 0.0011), pN(P = 0.0004), and pTR (P < 0.0001). Receiver operating characteristic (ROC) curves demonstrated the highest accuracy (AUC 0.75), sensitivity (88.9%) and specificity (60.9%) at the reduction rate of 53% (P = 0.007) which was approximated to the cutoff value we used. In univariate analysis of recurrence free survival (RFS), pT, pN, pM, CT response of both PT and LNs, and pTR were significantly correlated with RFS. Multivariate analysis further identified CT response of LNs (HR 2.68 P = 0.003) and pTR (HR 2.72 P = 0.022) to be independently associated with RFS. When classified into three groups by histological grade and CT response of LNs [group A (grade2–3/LNs-responders), group B (grade1a-1b/LNs-nonresponders), and group C (others)], 2-year RFS were 83% in the groupA, 59% in groupC and 29% in groupB (P < 0.0001), respectively. Conclusion In locally-advanced esophageal cancer patients with NACT followed by surgery, CT response of PT and LNs significantly correlated with pTR. Especially, CT response of LNs was important to predict prognosis in addition to pTR. Disclosure All authors have declared no conflicts of interest.

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