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Observational Study
. 2023 Sep;149(11):8213-8223.
doi: 10.1007/s00432-023-04729-8. Epub 2023 Apr 16.

Real-world surgical treatment patterns and clinical outcomes in patients with stages IA-IIIA non-small cell lung cancer: a retrospective multicentric observational study involving 11,958 patients

Daqiang Sun #  1 , Jian Hu #  2 , Xiaofei Li  3 , Jianxing He  4 , Lin Xu  5 , Xiangning Fu  6 , Yang Liu  7 , Deruo Liu  8 , Pingyan Chen  9 , Xun Zhang  1 , Lunxu Liu  10
Affiliations
Observational Study

Real-world surgical treatment patterns and clinical outcomes in patients with stages IA-IIIA non-small cell lung cancer: a retrospective multicentric observational study involving 11,958 patients

Daqiang Sun et al. J Cancer Res Clin Oncol. 2023 Sep.

Abstract

Purpose: Surgical resection is cornerstone treatment for early-stage non-small cell lung cancer (NSCLC) and offers a chance for cure. This study was conducted to determine current surgical treatment patterns and outcomes of Chinese patients with NSCLC.

Methods: Data of patients with histologically confirmed NSCLC of stages IA-IIIA and who underwent surgery between July 2014 and July 2020 were retrospectively collected from 9 tertiary hospitals in China. Cox model was used for multivariate analyses.

Results: This study included 11,958 patients, among whom 59.1%, 19.2%, and 21.7% were in stages I, II, and IIIA, respectively. Lobectomy was the most common operation method (78.4%), followed by wedge resection (8.2%), segmentectomy (5.4%), pneumonectomy (5.2%), and bronchial sleeve lobectomy (2.8%). Among patients who underwent wedge resection and segmentectomy, majority had stage I NSCLC (87.2% and 93.3%, respectively), and sublobectomy accounted for 20.7% of stage I operations. With a median follow-up time of 30.2 months, disease-free survival (DFS) and overall survival (OS) rates of entire population were 88.9% and 96.1% at 1 year, 75.2% and 85.1% at 3 years, and 65.3% and 77.0% at 5 years, respectively. The 5-year OS rates for stages IA, IB, IIA, IIB, and IIIA disease were 93.2%, 82.7%, 70.3%, 67.0%, and 52.1%, respectively.

Conclusion: This is the largest real-world cohort study of patients with NSCLC who underwent surgery in China, where we described characteristics of surgical treatment and survival outcomes. The results of our study provide insights into real-world surgical treatment status for surgeons and clinicians.

Keywords: 5-year survival; Non-small cell lung cancer; Real-world study; Surgery.

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Conflict of interest statement

Daqiang Sun, Jian Hu, Xiaofei Li, Jianxing He, Lin Xu, Xiangning Fu, Yang Liu, Deruo Liu, Pingyan Chen, Xun Zhang, and Lunxu Liu declare no conflict of interest.

Figures

Fig. 1
Fig. 1
The 5-year survival curves for the overall population: A disease-free survival and B overall survival
Fig. 2
Fig. 2
The 5-year overall survival curves according to different pathological stages
Fig. 3
Fig. 3
Subgroup analysis of 5-year overall survival curve by thoracoscopic surgery and thoracotomy: A whole group B Stage IA C Stage IB D Stage IIA E Stage IIB F Stage IIIA
See this image and copyright information in PMC

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