Clinical Guideline-Guided Outcome Consistency for Surgically Resected Stage III Non-Small Cell Lung Cancer: A Retrospective Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
Statistical Analyses
3. Results
3.1. Patient Flow Algorism
3.2. Patient Characteristics
3.3. Surgical Outcomes and Therapeutic Efficacy in Recurred Patients
3.4. To Investigate the Prognostic Factor for OS
3.5. Subgroup Analyses for OS
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
References
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Characteristics | Inconsistent | Consistent | p-Value | |
---|---|---|---|---|
n = 179 | n = 129 | |||
Age (years old), median | 67 | 63 | <0.01 | |
IQR | (61–73) | (58–67) | ||
Gender, male (%) | 104 (58.1%) | 73 (56.6%) | 0.79 | |
Era | 0.82 | |||
2006–2013 | 116 (64.8%) | 82 (63.6%) | ||
2014–2017 | 63 (35.2%) | 47 (36.4%) | ||
Smoking history (pack-year), median | 34.0 | 16.0 | 0.08 | |
IQR | (0–52.0) | (0–46.5) | ||
Prognostic nutritional index, median | 49.8 | 52.4 | <0.01 | |
IQR | (46.3–53.3) | (49.3–54.7) | ||
Clinical stage N (number, %) | 0.31 | |||
cN0 | 98 (54.7%) | 63 (48.8%) | ||
cN1–2 | 81 (45.3%) | 66 (51.2%) | ||
Clinical stage | 0.80 | |||
cI | 68 (38.0%) | 51 (39.5%) | ||
cII | 46 (25.7%) | 32 (24.8%) | ||
cIII | 65 (36.3%) | 46 (35.7%) | ||
Histology (number, %) | 0.05 | |||
Adenocarcinoma | 117 (65.4%) | 98 (76.0%) | ||
Others | 62 (34.6%) | 31 (24.0%) | ||
Type of procedures (number, %) | 0.02 | |||
Lobectomy | 149 (83.2%) | 119 (92.2%) | ||
Pneumonectomy/Bilobectomy | 30 (16.8%) | 10 (7.8%) | ||
ATCR (yes, %) | 35 (19.6%) | 129 (100%) | <0.01 | |
Pathological-Stage | <0.01 | |||
IIIA | 167 (93.2%) | 123 (95.3%) | ||
IIIB | 12 (6.7%) | 6 (4.7%) | ||
Single lymph node involvement | 0.35 | |||
(yes, %) | 29 (16.2%) | 16 (12.4%) | ||
Mutation status (yes/no/uninformative) | ||||
EGFR | 68/111/0 | 55/74/0 | 0.41 | |
ALK | 5/140/34 | 6/95/28 | 0.35 | |
BRAF | 0/62/117 | 0/40/89 | NA | |
ROS1 | 0/24/155 | 1/16/107 | NA | |
Treatment after recurrence (yes, %) | 136 (76.0%) | 74 (57.4%) | 0.04 | |
Local control | 26 (19.1%) | 7 (9.0%) | ||
Chemotherapy ± Radiotherapy | 55 (40.4%) | 21 (28.4%) | ||
Molecular target drug | 37 (27.2%) | 44 (59.5%) | ||
Immune checkpoint inhibitor | 4 (3.0%) | 2 (2.7%) | ||
Others | 14 (10.3%) | 0 (0%) |
Variables | Univariate | Multivariate | ||
---|---|---|---|---|
p-Value | Hazard Ratio (95% CI 1) | p-Value | ||
Patient characteristics | ||||
Age | <0.01 * | 1.02 (1.01–1.04) | 0.02 * | |
Male | <0.01 * | 0.73 (0.50–1.06) | 0.10 | |
Pack-year | 0.11 | |||
Prognostic nutritional index | ||||
Score < 50 | 0.02 * | 0.74 (0.54–1.03) | 0.08 | |
Era | ||||
2006–2013 | <0.01 * | 0.50 (0.33–0.76) | <0.01 * | |
Clinical N stage | ||||
N1–2 | 0.27 | |||
Histology | ||||
Adenocarcinoma | 0.57 | |||
Procedures | ||||
More than lobectomy | 0.81 | |||
Guideline | ||||
Inconsistent | <0.01 * | 0.49 (0.34–0.71) | <0.01 * | |
Any mutation | ||||
Yes | <0.01 * | 1.36 (0.94–1.97) | 0.10 | |
Pathological N status | ||||
Single involvement | 0.39 |
Characteristics | Inconsistent | Consistent | p-Value | |
---|---|---|---|---|
n = 106 | n = 108 | |||
Age (years old), median | 64 | 64 | 0.98 | |
IQR | (60–68) | (58–69) | ||
Gender, male (%) | 61 (57.5%) | 59 (54.6%) | 0.67 | |
Era | 0.97 | |||
2006–2013 | 69 (65.1%) | 70 (64.8%) | ||
2014–2017 | 37 (34.9%) | 38 (35.2%) | ||
Smoking history (pack-year), median | 20.0 | 32 | 0.49 | |
IQR | (0–49.1) | (0–50.8) | ||
Prognostic nutritional index, median | 0.81 | |||
IQR | 36 (34.0%) | 35 (32.4%) | ||
Any mutation (EGFR/ALK/BRAF/ROS1) | ||||
(yes, %) | 50 (47.2) | 50 (46.3%) | 0.90 |
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Kuroda, H.; Sugita, Y.; Masago, K.; Takahashi, Y.; Nakada, T.; Sasaki, E.; Sakakura, N.; Yamaguchi, R.; Matsushita, H.; Hida, T. Clinical Guideline-Guided Outcome Consistency for Surgically Resected Stage III Non-Small Cell Lung Cancer: A Retrospective Study. Cancers 2021, 13, 2531. https://doi.org/10.3390/cancers13112531
Kuroda H, Sugita Y, Masago K, Takahashi Y, Nakada T, Sasaki E, Sakakura N, Yamaguchi R, Matsushita H, Hida T. Clinical Guideline-Guided Outcome Consistency for Surgically Resected Stage III Non-Small Cell Lung Cancer: A Retrospective Study. Cancers. 2021; 13(11):2531. https://doi.org/10.3390/cancers13112531
Chicago/Turabian StyleKuroda, Hiroaki, Yusuke Sugita, Katsuhiro Masago, Yusuke Takahashi, Takeo Nakada, Eiichi Sasaki, Noriaki Sakakura, Rui Yamaguchi, Hirokazu Matsushita, and Toyoaki Hida. 2021. "Clinical Guideline-Guided Outcome Consistency for Surgically Resected Stage III Non-Small Cell Lung Cancer: A Retrospective Study" Cancers 13, no. 11: 2531. https://doi.org/10.3390/cancers13112531