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. 2019 Oct 30;19(1):1023.
doi: 10.1186/s12885-019-6141-z.

Postoperative chemoradiotherapy is superior to postoperative chemotherapy alone in squamous cell lung cancer patients with limited N2 lymph node metastasis

Liyu Su  1   2   3 , Mingqiu Chen  1   4 , Huiyan Su  5 , Yaqing Dai  6 , Shaoxing Chen  7 , Jiancheng Li  8
Affiliations

Postoperative chemoradiotherapy is superior to postoperative chemotherapy alone in squamous cell lung cancer patients with limited N2 lymph node metastasis

Liyu Su et al. BMC Cancer. .

Abstract

Background: The aim of the present study was to assess the efficacy of postoperative chemoradiotherapy (POCRT) following surgery in non-small-cell lung cancer patients with N2 lymph node metastasis (N2-NSCLC).

Methods: The clinical data of patients with N2-NSCLC treated with POCRT or postoperative chemotherapy (pCT) alone were retrospectively collected and reviewed. The overall survival (OS) rates were analyzed utilizing the Kaplan-Meier method and compared by the log-rank test. Cox regression analysis was used to determine factors significantly associated with survival. Propensity score matching (PSM) analysis was used to compensate for differences in baseline characteristics and OS was compared after matching.

Results: Between 2004 and 2014, a total of 175 patients fulfilled the inclusion criteria, 60 of whom were treated with POCRT, while 115 were administered pCT. The 1, 3 and 5-year OS rates in the POCRT and pCT groups were 98.3 vs. 86.1%, 71.7 vs. 53.0% and 45.7 vs. 39.0%, respectively (P = 0.019). Compared with pCT, POCRT improved OS in patients with squamous cell subtype (P = 0.010), no lymphovascular invasion (P = 0.006), pN2a (P = 0.006) or total number of metastatic lymph nodes ≤7 (P = 0.016). After PSM, these survival differences between POCRT and pCT remained significant in patients with squamous cell lung cancer (P = 0.010).

Conclusions: POCRT following complete resection may be beneficial for patients with squamous cell lung cancer, particularly those with limited nodal involvement.

Keywords: N2 lymph node metastasis; Non-small-cell lung cancer; Postoperative chemoradiotherapy; Survival.

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Conflict of interest statement

The authors declare the submitted work was not carried out in the presence of any personal, professional or financial relationships that could potentially be construed as a conflict of interest.

Figures

Fig. 1
Fig. 1
Comparison of OS between pCT alone and POCRT before and after matching. a. Comparison of OS between pCT alone and POCRT before matching. b. Comparison of OS between pCT alone and POCRT after matching. OS, overall survival; pCT, postoperative chemotherapy; POCRT, postoperative chemoradiotherapy
Fig. 2
Fig. 2
a.The ROC curve of the cut-off number of MLNs. b. Comparison of OS between ≤7 MLNs and > 7 MLNs
Fig. 3
Fig. 3
OS in various subgroups of independent significant factors. OS, overall survival. a. Comparison of OS between pCT alone and POCRT in patients with squamous cell carcinoma before matching. b. Comparison of OS between pCT alone and POCRT in patients with squamous cell carcinoma after matching. c. Comparison of OS between pCT alone and POCRT in patients with without lymphovascular invasion before matching. d. Comparison of OS between pCT alone and POCRT in patients with without lymphovascular invasion after matching. e. Comparison of OS between pCT alone and POCRT in patients with ≤7 MLNs before matching. f. Comparison of OS between pCT alone and POCRT in patients with ≤7 MLNs after matching. g. Comparison of OS between pCT alone and POCRT in patients with pN2a before matching. h. Comparison of OS between pCT alone and POCRT in patients with pN2a after matching. OS, overall survival; pCT, postoperative chemotherapy; POCRT, postoperative chemoradiotherapy; scc, squamous cell carcinoma; non-vessel invasion, without lymphovascular invasion; MLNs≤7, metastatic lymph nodes≤7; pN2a, Combine pN2a1 and pN2a2, N2 at a single station without N1 involvement (‘skip’ metastasis, N2a1), N2 at a single station with N1 involvement (N2a2)
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References

    1. Bray Freddie, Ferlay Jacques, Soerjomataram Isabelle, Siegel Rebecca L., Torre Lindsey A., Jemal Ahmedin. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018;68(6):394–424. - PubMed
    1. Didkowska J, Wojciechowska U, Manczuk M, Lobaszewski J. Lung cancer epidemiology: contemporary and future challenges worldwide. Ann Transl Med. 2016;4:150. doi: 10.21037/atm.2016.03.11. - DOI - PMC - PubMed
    1. Travis WD, Brambilla E, Nicholson AG, Yatabe Y, Austin JHM, Beasley MB, Chirieac LR, Dacic S, Duhig E, Flieder DB, Geisinger K, Hirsch FR, Ishikawa Y, Kerr KM, Noguchi M, Pelosi G, Powell CA, Tsao MS, Wistuba I, Panel WHO. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol. 2015;10:1243–1260. doi: 10.1097/JTO.0000000000000630. - DOI - PubMed
    1. Howlader N, Noone A, Krapcho M. SEER Cancer Statistics Review, 1975-2014. Bethesda, MD: National Cancer Institute; 2017. Based on November 2016 SEER data submission, posted to the SEER web site. https://seer.cancer.gov/archive/csr/1975_201
    1. Robinson CG, Patel AP, Bradley JD, DeWees T, Waqar SN, Morgensztern D, Baggstrom MQ, Govindan R, Bell JM, Guthrie TJ. Postoperative radiotherapy for pathologic N2 non–small-cell lung cancer treated with adjuvant chemotherapy: A review of the National Cancer Data Base. J Clin Oncol. 2015;33:870. doi: 10.1200/JCO.2014.58.5380. - DOI - PMC - PubMed

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