Residual cancer burden after neoadjuvant therapy in lung cancer: A single-institution cohort.

Abstract

e20050 Background: Residual cancer burden (RCB) after neoadjuvant therapy may predict recurrence and survival, but real-world data in lung cancer are limited. We evaluated RCB, clinical characteristics, and outcomes in a single-institution cohort. Methods: We retrospectively analyzed 53 patients (RCB classes pCR,1,2,3) treated with neoadjuvant therapy. Baseline demographics (age, sex, BMI, tobacco history), recurrence, and overall survival were compared across RCB classes. Cox proportional hazards models assessed the association of RCB with mortality, adjusting for age, sex, BMI, and tobacco history. Results: Baseline characteristics were similar across RCB classes. Recurrence rates increased with RCB class (pCR: 14.3%, 1: 20%, 2: 10%, 3: 25%). Mortality also trended higher with increasing RCB (pCR: 7.1%, 1: 20%, 2: 13.3%, 3: 50%). In fully adjusted Cox models, RCB 3 vs pCR showed a non-significant trend toward higher mortality (HR 4.98, 95% CI 0.49–50.7, p = 0.175). Age was independently associated with mortality (HR 1.10 per year, 95% CI 1.01–1.19, p = 0.025). Conclusions: Higher RCB may be associated with increased mortality in lung cancer, though statistical significance was not reached, likely due to small sample size. Age was an independent predictor of mortality. These findings suggest that RCB could inform post-neoadjuvant risk stratification, but larger studies are needed to confirm its prognostic value.