Surgery is a promising strategy for improving overall survival for stage III-N2 non-small cell lung cancer patients.

Surgery is commonly used to treat stage I lung cancer patients, whereas radiotherapy is applied to treat stage III lung cancer patients. However, few advanced-stage lung cancer patients benefit from surgery. This study aimed to investigate the efficacy of surgery for stage III-N2 non-small cell lung cancer (NSCLC) patients. A total of 204 patients with stage III-N2 NSCLC were included and divided into surgery (n=60) and radiotherapy (n=144) groups. The clinical characteristics [tumor node metastasis (TNM) stage, and adjuvant chemotherapy] and basic information (gender, age, and smoking/family history) of the included patients were evaluated. Furthermore, the patients' Eastern Cooperative Oncology Group (ECOG) scores and comorbidities were also evaluated, and the Kaplan-Meier approach was utilized to analyze their overall survival (OS). A multivariate Cox proportional hazards model was generated to analyze OS. There was a significant difference in disease stages (IIIa and IIIb) between the surgery and radiotherapy groups (P<0.001). Compared with the surgery group, there were more patients with ECOG scores of 1 and 2 and fewer patients with ECOG scores of 0 in the radiotherapy group (P<0.001). Moreover, there was a significant difference in comorbidities between the stage III-N2 NSCLC patients in the two groups (P=0.011). The OS rate was higher significantly in stage III-N2 NSCLC patients in the surgery group compared to that in the radiotherapy group (P<0.05). Kaplan-Meier analysis demonstrated that the OS of III-N2 NSCLC was markedly better in the surgery group compared to the radiotherapy group (P<0.05). The multivariate proportional hazards model showed that age, T stage, surgery, disease stage, and adjuvant chemotherapy were independent prognostic predictors for OS in stage III-N2 NSCLC patients. Surgery is associated with improved OS in stage III-N2 NSCLC patients and is recommended to treat these patients. 2023 Journal of Thoracic Disease. All rights reserved.

Citation

Jie Yang, Chao Jiang, Yue Wang, Rong Qiu, Jingwei Su, Changjiang Liu, Li Jing. Surgery is a promising strategy for improving overall survival for stage III-N2 non-small cell lung cancer patients. Journal of thoracic disease. 2023 Mar 31;15(3):1426-1432

PMID: 37065550

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