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
{"title":"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）","authors":"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","doi":"10.1016/j.lungcan.2024.107868","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"194 ","pages":"Article 107868"},"PeriodicalIF":4.5000,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0169500224004021/pdfft?md5=58189a66e935ae87e985ed81b74a96a3&pid=1-s2.0-S0169500224004021-main.pdf","citationCount":"0","resultStr":"{\"title\":\"A prospective analysis of the management practices for patients with Stage-III-N2Non-Small-Cell lung cancer (OBSERVE IIIA–B GFPC 04-2020Study)\",\"authors\":\"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\",\"doi\":\"10.1016/j.lungcan.2024.107868\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusion</h3><p>The results of this study highlight substantial disparities amongFrench TBMs regarding therapeutic management of stage-III-N2 NSCLC. 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A prospective analysis of the management practices for patients with Stage-III-N2Non-Small-Cell lung cancer (OBSERVE IIIA–B GFPC 04-2020Study)
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.
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.
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