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. 2017 Oct;9(10):4046-4056.
doi: 10.21037/jtd.2017.10.47.

Optimal managements of stage IIIA (N2) non-small cell lung cancer patients: a population-based survival analysis

Zhaofei Pang  1 , Yufan Yang  1 , Nan Ding  1 , Cuicui Huang  1 , Tiehong Zhang  2 , Yang Ni  2 , Jiajun Du  1   3 , Qi Liu  1
Affiliations

Optimal managements of stage IIIA (N2) non-small cell lung cancer patients: a population-based survival analysis

Zhaofei Pang et al. J Thorac Dis. 2017 Oct.

Abstract

Background: This study aimed to investigate the optimal management of stage IIIA (cN2) non-small cell lung cancer (NSCLC) patients and determine potential predictive factors.

Methods: We extracted patients diagnosed as NSCLC stage IIIA (cN2) between 2004 and 2011 from Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared among patients given different clinical managements by Kaplan-Meier method. Other variables such as age, sex and tumor size were analyzed to explore the factors associated with outcomes.

Results: A total of 98,700 IIIA-cN2 NSCLC patients were identified from SEER database. Survival of patients treated with surgery was better than that of patients treated by radiotherapy alone (P<0.001). Radiation prior to surgery significantly improved the survival in comparison with surgery alone (P<0.001). In the subgroups of OS analysis, age >65 (P=0.902), adenocarcinoma (P=0.279), tumor size ≤3 cm (P=0.170), well differentiated (P=0.360) patients, preoperative radiotherapy improved survival insignificantly compared with surgery alone.

Conclusions: Preoperative radiation with surgery had the most encouraging survival outcomes in stage IIIA-cN2 NSCLC patients compared with radiation or surgery alone. No significant outcome improvement was shown between postoperative radiotherapy (PORT) and surgery alone.

Keywords: Stage IIIA (N2); non-small cell lung cancer (NSCLC); postoperative radiotherapy (PORT); preoperative radiotherapy; radiotherapy; surgery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The Kaplan-Meier curves of OS in overall and subgroup patients. OS, overall survival.
Figure 2
Figure 2
The Kaplan-Meier curves of LCSS in overall and subgroup patients. LCSS, lung cancer specific survival.
See this image and copyright information in PMC

References

    1. Rosen JE, Hancock JG, Kim AW, et al. Predictors of mortality after surgical management of lung cancer in the National Cancer Database. Ann Thorac Surg 2014;98:1953-60. 10.1016/j.athoracsur.2014.07.007 - DOI - PubMed
    1. Mountain CF. Staging classification of lung cancer. A critical evaluation. Clin Chest Med 2002;23:103-21. 10.1016/S0272-5231(03)00063-7 - DOI - PubMed
    1. Sawabata N, Miyaoka E, Asamura H, et al. Japanese lung cancer registry study of 11,663 surgical cases in 2004: demographic and prognosis changes over decade. J Thorac Oncol 2011;6:1229-35. 10.1097/JTO.0b013e318219aae2 - DOI - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin 2017;67:7-30. 10.3322/caac.21387 - DOI - PubMed
    1. Vansteenkiste J, Betticher D, Eberhardt W, et al. Randomized controlled trial of resection versus radiotherapy after induction chemotherapy in stage IIIA-N2 non-small cell lung cancer. J Thorac Oncol 2007;2:684-5. 10.1097/JTO.0b013e31811f47ad - DOI - PubMed

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