Year 2019, Volume 21 , Issue 1, Pages 28 - 36 2019-04-30

CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY
Neoadjuvan Kemoterapi ile Tedavi Edilen Lokal İleri Evre Küçük Hücreli Dışı Akciğer Kanseri Hastalarının Sağkalımında Histopatolojik Yanıt ve Prognostik Belirteçlerin Korelasyonu

Samed RAHATLI [1] , Nadire KÜÇÜKÖZTAŞ [2] , Selim YALÇIN [3] , Merih TEPEOĞLU [4] , Dalokay KILIÇ [5]


ObjectiveWe aimed to determine the response and prognosis to neoadjuvant chemotherapy in patients with stage III non-small-cell lung cancer (NSCLC) who had received neoadjuvant therapy and to determine the relationship with prognosis and treatment response of the expression of excision repair cross-complementation group 1 protein (ERCC1) and Ribonucleotide reductase regulatory subunit M1 (RRM1) protein.

Material and Methods: Twenty-seven patients with stage III NSCLC who received neoadjuvant chemotherapy and had been operated between 2003 and 2013 were included in this study. Lung tissue biopsies were evaluated by immunohistochemical methods for ERCC1 protein expression in patients who received cisplatin and RRM1 protein expression who received gemcitabine.

Results: Median age was 59 (45-75). Nineteen patients (70.4%) were at stage IIIA and eight patients (29.6 %) were at stage IIIB. All patients received neoadjuvant cisplatin-based chemotherapy. Fifteen patients (55.6%) relapsed during follow-up. The median follow-up time was 36 months. The median disease-free survival (DFS) was 26.6 months, overall survival (OS) was 48 months. From the perspective of stage IIIA and IIIB DFS (p=0.379) and OS (p=0.69) did not differ significantly. Sixteen patients’ (59.3%) viable tumor ratio was ≤10%, 11 patients’ (40%) viable tumor ratio was >10%. When considered from this point of view DFS (p=0.16) and OS (p=0.097) showed no difference. More patients survived in the low ERCC1 expression group. Patients with low ERCC1 expression and patients with high ERCC1 expression showed no difference in terms of survival.

Conclusion: Patients with high RRM1 expression showing resistance to gemcitabine and with low RRM1 expression had similar survival rates. In patients with stage III NSCLC who received neoadjuvant chemotherapy, OS and DFS durations longer than literature were found.

Amaç: Neoadjuvan kemoterapi almış olan evre III küçük hücreli dışı akciğer kanserli (KHDAK) hastalarda neoadjuvan tedavi yanıtlarının belirlenmesi ile, prognoza katkısı ile eksizyon   onarım çapraz-tamamlayıcı grup 1 (ERCC1) ve Ribonükleotid Redüktaz alt ünitesi Ml (RRM1) ekspresyonunun tedavi yanıtı ve prognozla ilişkisinin belirlenmesini hedeflendi.

Gereç ve Yöntemler: Bu çalışmaya 2003-2013 yılları arasında Evre III KHDAK tanısıyla neoadjuvan kemoterapi alıp 27 hasta dahil edildi. Neoadjuvan cisplatin alan hastaların akciğer biyopsi dokularında ERCC1 ve gemsitabin alan hastaların biyopsi materyallerinde RRM1 protein ekpresyonu immünohistokimyasal yöntemle değerlendirildi.

Bulgular: Medyan yaş 59 (45-75)’du. Hastaların 19 (%70.4)’u evre IIIA, 8 (%29.6)’i evre IIIB idi. Hastaların hepsi cisplatin bazlı neoadjuvan kemoterapi aldı. Hastaların 15 (%55.6)’inin takiplerinde nüks tespit edildi. Ortanca takip süresi 36 aydı. Tüm olgulara ilişkin ortalama hastalıksız sağ kalım (HSK) 26.6 aydı. Genel sağkalım (GSK) ise 48 ay olarak bulundu. Evre IIIA ve IIIB açısından bakıldığında HSK (p=0.379) ve GSK (p=0.69) açısından anlamlı fark bulunmadı. Hastaların 16 (%59.3)’sında neoadjuvan KT sonrası cerrahi patoloji materyallerinde viabl tümör oranı %10 ve altında, 11 (%40) hastada ise viabl tümör oranı %10’nun üstünde bulundu. Bu açıdan da değerlendirildiğinde HSK (p=0.16) ve GSK (p=0.097) farkı saptanmadı. Düşük ERCC1 ekspresyonu olan hastalarla yüksek ERCC1 ekspresyonu olan hastalar arasında sağkalım farkı saptanmadı. Gemsitabin direncini gösteren RRM1 yüksek ekpresyonu olan hastalar da düşük ekspresyon olan hastalar ile benzer sağ kalım oranlarına sahipti.

SonuçÇalışmamızda neoadjuvan kemoterapi alan evre III KHDAK’li hastalarda HSK ve GSK süreleri genel verilere göre daha uzun bulundu. Sisplatin ve gemsitabin tedavisi açısından prediktif markerlar olan ERCC1 ve RRM1 ile tedavi yanıtı ve sağkalım arasında anlamlı ilişki bulunmadı.

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Primary Language en
Subjects Health Care Sciences and Services
Published Date 2019/1
Journal Section Articles
Authors

Author: Samed RAHATLI (Primary Author)
Institution: BAŞKENT ÜNİVERSİTESİ, TIP FAKÜLTESİ
Country: Turkey


Author: Nadire KÜÇÜKÖZTAŞ
Institution: BAŞKENT ÜNİVERSİTESİ, TIP FAKÜLTESİ

Author: Selim YALÇIN
Institution: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ

Author: Merih TEPEOĞLU
Institution: BAŞKENT ÜNİVERSİTESİ, TIP FAKÜLTESİ

Author: Dalokay KILIÇ
Institution: BAŞKENT ÜNİVERSİTESİ, TIP FAKÜLTESİ

Dates

Publication Date : April 30, 2019

Bibtex @research article { kutfd465529, journal = {Kırıkkale Üniversitesi Tıp Fakültesi Dergisi}, issn = {1302-3314}, eissn = {2148-9645}, address = {}, publisher = {Kirikkale University}, year = {2019}, volume = {21}, pages = {28 - 36}, doi = {10.24938/kutfd.465529}, title = {CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY}, key = {cite}, author = {RAHATLI, Samed and KÜÇÜKÖZTAŞ, Nadire and YALÇIN, Selim and TEPEOĞLU, Merih and KILIÇ, Dalokay} }
APA RAHATLI, S , KÜÇÜKÖZTAŞ, N , YALÇIN, S , TEPEOĞLU, M , KILIÇ, D . (2019). CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi , 21 (1) , 28-36 . DOI: 10.24938/kutfd.465529
MLA RAHATLI, S , KÜÇÜKÖZTAŞ, N , YALÇIN, S , TEPEOĞLU, M , KILIÇ, D . "CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY". Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 21 (2019 ): 28-36 <https://dergipark.org.tr/en/pub/kutfd/issue/38689/465529>
Chicago RAHATLI, S , KÜÇÜKÖZTAŞ, N , YALÇIN, S , TEPEOĞLU, M , KILIÇ, D . "CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY". Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 21 (2019 ): 28-36
RIS TY - JOUR T1 - CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY AU - Samed RAHATLI , Nadire KÜÇÜKÖZTAŞ , Selim YALÇIN , Merih TEPEOĞLU , Dalokay KILIÇ Y1 - 2019 PY - 2019 N1 - doi: 10.24938/kutfd.465529 DO - 10.24938/kutfd.465529 T2 - Kırıkkale Üniversitesi Tıp Fakültesi Dergisi JF - Journal JO - JOR SP - 28 EP - 36 VL - 21 IS - 1 SN - 1302-3314-2148-9645 M3 - doi: 10.24938/kutfd.465529 UR - https://doi.org/10.24938/kutfd.465529 Y2 - 2019 ER -
EndNote %0 Kırıkkale Üniversitesi Tıp Fakültesi Dergisi CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY %A Samed RAHATLI , Nadire KÜÇÜKÖZTAŞ , Selim YALÇIN , Merih TEPEOĞLU , Dalokay KILIÇ %T CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY %D 2019 %J Kırıkkale Üniversitesi Tıp Fakültesi Dergisi %P 1302-3314-2148-9645 %V 21 %N 1 %R doi: 10.24938/kutfd.465529 %U 10.24938/kutfd.465529
ISNAD RAHATLI, Samed , KÜÇÜKÖZTAŞ, Nadire , YALÇIN, Selim , TEPEOĞLU, Merih , KILIÇ, Dalokay . "CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY". Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 21 / 1 (April 2019): 28-36 . https://doi.org/10.24938/kutfd.465529
AMA RAHATLI S , KÜÇÜKÖZTAŞ N , YALÇIN S , TEPEOĞLU M , KILIÇ D . CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY. Kirikkale Univ Tip Fak Derg. 2019; 21(1): 28-36.
Vancouver RAHATLI S , KÜÇÜKÖZTAŞ N , YALÇIN S , TEPEOĞLU M , KILIÇ D . CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2019; 21(1): 36-28.