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    CORRELATION OF HISTOPATHOLOGIC RESPONSE AND PROGNOSTIC MARKERS WITH THE SURVIVAL IN LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY
    (2019) Rahatlı, Samet; Kucukoztas, Nadire; Yalçın, Selim; Tepeoğlu, Merih; Kılıç, Dalokay; Altundağ, Özden
    Objective: We aimed to determine the response and prognosis toneoadjuvant chemotherapy in patients with stage III non-smallcell lung cancer (NSCLC) who had received neoadjuvant therapyand to determine the relationship with prognosis and treatmentresponse of the expression of excision repair crosscomplementation group 1 protein (ERCC1) and Ribonucleotidereductase regulatory subunit M1 (RRM1) protein.Material and Methods: Twenty-seven patients with stage IIINSCLC who received neoadjuvant chemotherapy and had beenoperated between 2003 and 2013 were included in this study.Lung tissue biopsies were evaluated by immunohistochemicalmethods for ERCC1 protein expression in patients who receivedcisplatin and RRM1 protein expression who receivedgemcitabine.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 medianfollow-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) andOS (p=0.69) did not differ significantly. Sixteen patients’ (59.3%)viable tumor ratio was ?10%, 11 patients’ (40%) viable tumorratio was >10%. When considered from this point of view DFS(p=0.16) and OS (p=0.097) showed no difference. More patientssurvived in the low ERCC1 expression group. Patients with lowERCC1 expression and patients with high ERCC1 expressionshowed no difference in terms of survival.Conclusion: Patients with high RRM1 expression showingresistance to gemcitabine and with low RRM1 expression hadsimilar survival rates. In patients with stage III NSCLC whoreceived neoadjuvant chemotherapy, OS and DFS durationslonger than literature were found.