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01.12.2017 | Research | Ausgabe 1/2017 Open Access

Radiation Oncology 1/2017

Choice of postoperative radiation for stage IIIA pathologic N2 non-small cell lung cancer: impact of metastatic lymph node number

Zeitschrift:
Radiation Oncology > Ausgabe 1/2017
Autoren:
Siwei Wang, Zhifei Ma, Xiangbao Yang, Yajing Wang, Youtao Xu, Wenjia Xia, Rui Chen, Mantang Qiu, Feng Jiang, Rong Yin, Lin Xu, Keping Xu
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s13014-017-0946-1) contains supplementary material, which is available to authorized users.

Abstract

Background

Postoperative radiation (PORT) is an option for non-small cell lung cancer (NSCLC) patients with resectable stage IIIA pathological N2 status (pN2). For patients with PORT, this study aims to investigate the impact of the exact number of positive lymph nodes (LNs) on overall survival (OS) and lung cancer-specific survival (LCSS).

Methods

Within the Surveillance, Epidemiology, and End Results database, we identified 3373 patients with stage IIIA pathological N2 status (pN2) NSCLC who underwent a lobectomy or pneumonectomy from 2004 to 2013. OS and LCSS were compared among patients coded as receiving PORT or observation. The proportional hazards model was applied for investigation.

Results

OS and LCSS favored PORT for patients with stage IIIA (pN2) NSCLC. Multivariable analyses showed that PORT and the exact number of positive LNs (n ≤ 3) were independently associated with better OS and LCSS. Both better OS and LCSS emerged for positive LNs (n > 3) after the use of PORT in survival analyses, whereas the benefits of OS and LCSS were not observed anymore for positive LNs (n ≤ 3) group. More importantly, multivariable analyses showed that the use of PORT is an independent risk factor of survival for positive LNs (n > 3) but not for positive LNs (n ≤ 3).

Conclusions

In Stage IIIA (pN2) NSCLC, the use of PORT demonstrated better survival results than no PORT for patients with positive LNs (n > 3), but not for patients with positive LNs (n ≤ 3).
Zusatzmaterial
Additional file 1: Table S1. Cox proportional hazards regression model for overall survival and lung cancer-specific survival in patients with stage IIIA pN2 status NSCLC. Abbreviations: NSCLC, Non-small cell lung cancer. NOS, Not Otherwise Specified. Table S2. Cox proportional hazards regression model for overall survival and lung cancer-specific survival in patients with stage IIIA pN2 status NSCLC. (No. of positive lymph nodes in two categories). Abbreviations: NSCLC, Non-small cell lung cancer. NOS, Not Otherwise Specified. Table S3. Baseline characteristics of Patients with NSCLC in overall survival analysis. *: 4, 5, 6, ≥7, these four categoric variables were designed for the right two columns. Abbreviations: NSCLC, Non-small cell lung cancer. NOS, Not Otherwise Specified. Table S4. Baseline characteristics of Patients with NSCLC in lung cancer-specific survival analysis. *: 4, 5, 6, ≥7, these four categoric variables were designed for the right two columns. Abbreviations: NSCLC, Non-small cell lung cancer. NOS, Not Otherwise Specified. (DOCX 68 kb)
13014_2017_946_MOESM1_ESM.docx
Literatur
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