GTNs have excellent prognosis if properly treated at experienced centers. Single-agent dactinomycin seems more effective for low-risk GTN. EMA-CO remains the preferred primary treatment regimen for high-risk group. The excellent outcome reflects the success of salvage therapy.

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Background: Surgery is the fundamental treatment for stage I-IIIA patients. But treatment patterns in different areas of China diverse. In order to deliver high quality care for lung cancer patients, the Chinese National NSCLC outcome registry was founded in 2013, which covers 16 provinces in China. We analyze the data retrieved from this registry. Methods: Data of stage I-IIIa patients were obtained from the NSCLC surgical outcome registry, which included 2040 patients who underwent lung resection surgeries from 20 tertiary hospitals nationwide in 2013. 11 centers which have submitted more than 30 cases in 2013 were included. Stage I-IIIa NSCLC patients from these centers were retrieved. Baseline data, surgical parameters, pathology, number of lymph nodes dissected, and total hospital cost were analyzed. Results: Among the 2040 patients, the mean age was 60.1, while 1297 were male. Mean pre-op forced expiratory volume in 1 second (FEV1) was 2.39 L, FEV1/FVC was 80.1%. 8% patients combined with at least one comorbidity. The average diameter of the tumor was 3.15 cm. Mean operation time was 174 minutes. The post-operative pathology confirmed 62.0% as adenocarcinoma while 31.1% as squamous carcinoma. Based on the data submitted by different centers, 79.5% (mean, 0 to 98.41) patients who were confirmed as stage III patients received adjuvant therapy before surgery. The rate of minimally invasive surgery was 44.9% (mean, 8.1% to 94.7%) in different regions. The number of stations of lymph nodes harvested was 5.8 (mean, 4.3 to 7.4). Mean hospital cost was 55,070 (43,051 to 69,686) RMB.

Results: Fifty-one patients were included with a median age of 53 (37-77), of which 24 (45%) were premenopausal. The median tumour size was 29 mm (17-48). Ten patients had lymph node-positive disease. Based on the St. Gallen criteria. 30 patients were classified as luminal A and 21 as luminal B. Tamoxifen was started in pre-and an aromatase inhibitor in postmenopausal patients, with a median duration of 8 months (4-14) until surgery. Four patients switched therapy because of stable or progressive disease at 3-month evaluation. Radiological complete response was observed in seven patients (14%), partial response in 32 (64%) and stable disease in 10 (20%) patients. Major pathological response was observed in 12.5% of the cases. Of the eleven patients in whom mastectomy had been indicated initially, seven (7/11; 64%) were eligible for BCS after NET. Because of lymph node-positive disease or a second progressive lesion found post-operatively, five (10%) patients received adjuvant chemotherapy.Conclusions: Based on this relatively small series, treating patients with a low-risk 70gene signature with neoadjuvant endocrine therapy seems feasible. The pathological response rate and conversion to breast-conserving surgery are of clinical relevance and deserve validation in a larger study.Legal entity responsible for the study: Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital (NKI-AVL).

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