Beschreibung:
<jats:p> e11574 </jats:p><jats:p> Background: Chemotherapy, chemoradiotherapy, or radiotherapy is sometimes used to treat non-small cell lung cancer (NSCLC) before surgical resection (neoadjuvant therapy). However, no histopathological evaluation method for predicting the outcome of NSCLC treated by neoadjuvant therapy has been fully assessed. The purpose of this study was to assess a novel histopathological evaluation method for predicting the outcome of NSCLC patients who received neoadjuvant therapy followed by surgical resection. Methods: We reviewed the histopathology of the tumors of 61 NSCLC patients who received neoadjuvant chemotherapy, chemoradiotherapy, or radiotherapy and identified the histological features produced by neoadjuvant therapy by comparing them with the histopathological features of the tumors in 138 NSCLC cases treated by surgery without neoadjuvant therapy. We also measured the area of residual tumor (ART) on the maximum cut surface of the tumors and analyzed the relationships between the histological features, ART, and the outcome. Results: The proportions of cases with the histological features “cholesterin clefts,” “foreign body reactive giant cells,” “stromal hyalinosis,” and “cancer cells more than 50% of which contained a bizarre nucleus” were significantly higher in the neoadjuvant therapy group than in the surgery alone group. However, the presence of none of these features except “stromal hyalinosis” had any significant effect on survival in the neoadjuvant therapy group. Although pathological T factor (ypT) and N factor (ypN) had no significant effect on overall survival, smaller ART (≤400 mm<jats:sup>2</jats:sup>) and absence of pleural invasion (p(-)) were predictors of a outcome (p=0.004 and p=0.001, respectively). Conclusions: Smaller ART (≤400 mm<jats:sup>2</jats:sup>) and p(-) predict a better outcome of NSCLC in patients who receive neoadjuvant therapy. We concluded that ART is a novel histopathological parameter for predicting the outcome of NSCLC patients who receive neoadjuvant therapy followed by surgical resection. </jats:p><jats:p> No significant financial relationships to disclose. </jats:p>