A prospective analysis of the management practices for patients with Stage-III-N2Non-Small-Cell lung cancer (OBSERVE IIIA–B GFPC 04-2020Study)

IF 4.5 2区医学 Q1 ONCOLOGY Lung Cancer Pub Date : 2024-07-11 DOI:10.1016/j.lungcan.2024.107868

Mathilde Jacob , Pierre Fournel , Claire Tissot , Jacques Cadranel , Olivier Bylicki , Isabelle Monnet , Grégoire Justeau , Charles Ricordel , Pascal Thomas , Lionel Falchero , Chrystel Locher , Marie Wislez , Alain Vergnenegre , Samir Abdiche , Floran Guisier , Acya Bizieux , Regine Lamy , Geraldine François , Gonzagues De Chabot , Thomas Pierret , Laurent Greillier

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Abstract

Background

Management of stage-III-N2 non-small-cell lung cancer (NSCLC) based on a multimodal strategy (surgery or radiotherapycombined with systemic drugs) remains controversial. Patients are treated with a curative intent, and available data suggestprolonged survival after complete resection. However, no consensual definition of “tumor resectability” exists. This study aimed to analyze the concordanceamong French tumor board meeting (TBM)-emittedtherapeutic decisions forstage-III-N2 NSCLC.

Methods

Six patients with stage-III-N2 NSCLC discussed at Saint-Etienne University Hospital’sthoracic TBMs were selected, anonymouslyreported, and submitted to the participating TBMs. The primary goal of this multicenter, prospective, observational study was to assess the consistency of TBMpanel decisions for each case. The secondary endpointwas identifying the demographic or technical factors that potentiallyaffected decision-making.

Results

Twenty-seven TBMs from university hospitals, a cancer center, general hospitals, and a private hospitalparticipated in this study. None of their decisions for the six cases were unanimous.The decisions were homogenous for three cases (78%, 85%, and 88% TBMs opted for medical treatment, respectively),andmore ambivalent for the other three (medical versus surgical strategies were favored by 44%/56%, 46%/54%, and 58%/42% TBMs, respectively). Interestingly, decisions regarding chemoradiationand perioperative chemotherapyinthe medical and surgical strategies, respectively, were also discordant. Hospital type, specialist participation in TBMs, and activity volumes were not significantly associated with therapeutic decisions.

Conclusion

The results of this study highlight substantial disparities amongFrench TBMs regarding therapeutic management of stage-III-N2 NSCLC. The decisions were not associated with local conditions.

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对 III-N2 期非小细胞肺癌患者管理方法的前瞻性分析（OBSERVE IIIA-B GFPC 04-2020 研究）

背景对 III-N2 期非小细胞肺癌（NSCLC）的多模式治疗（手术或放疗结合全身用药）仍存在争议。患者接受治疗的目的是治愈，现有数据表明完全切除后患者的生存期延长。然而，目前对 "肿瘤可切除性 "尚无一致的定义。本研究旨在分析法国肿瘤委员会会议（TBM）发布的 III-N2 期 NSCLC 治疗决定的一致性。方法选取圣埃蒂安大学医院胸科 TBM 讨论的 6 例 III-N2 期 NSCLC 患者，匿名报告并提交给参与的 TBM。这项多中心、前瞻性、观察性研究的主要目的是评估治疗管理小组对每个病例的决定是否一致。结果来自大学医院、癌症中心、综合医院和一家私立医院的 27 名技术管理专家参与了这项研究。他们对六个病例的决策没有一个是一致的。三个病例的决策是一致的（分别有 78%、85% 和 88% 的 TBM 选择内科治疗），另外三个病例的决策则比较矛盾（分别有 44%/56%、46%/54% 和 58%/42% 的 TBM 选择内科治疗还是外科治疗）。有趣的是，内科和外科手术策略中关于化学放疗和围手术期化疗的决定也不一致。医院类型、TBM 中的专家参与情况以及活动量与治疗决策无明显关联。这些决定与当地条件无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.