Postoperative radiotherapy is associated with better survival in non-small cell lung cancer with involved N2 lymph nodes: results of an analysis of the National Cancer Data Base
| Autor: | Dana Nickleach, Suresh S. Ramalingam, Walter J. Curran, Yuan Liu, Fadlo R. Khuri, Kristin Higgins, Taofeek K. Owonikoko, Seth D. Force, Theresa W. Gillespie, Joseph Lipscomb, Rathi N. Pillai, William A. Hall, Felix G. Fernandez, R.S. Rajpara, J.L. Mikell |
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| Rok vydání: | 2014 |
| Předmět: |
Oncology
Pulmonary and Respiratory Medicine Adult Male medicine.medical_specialty Lung Neoplasms Databases Factual medicine.medical_treatment Article 03 medical and health sciences 0302 clinical medicine Internal medicine Carcinoma Non-Small-Cell Lung Neoplasms medicine Humans Lung cancer Survival rate 030304 developmental biology Aged Neoplasm Staging Retrospective Studies Aged 80 and over Postoperative Care 0303 health sciences Proportional hazards model business.industry Hazard ratio Retrospective cohort study Middle Aged medicine.disease Prognosis Combined Modality Therapy Confidence interval 3. Good health Surgery Radiation therapy Survival Rate 030220 oncology & carcinogenesis Propensity score matching Lymph Node Excision Female Radiotherapy Adjuvant Lymph Nodes Neoplasm Grading business Follow-Up Studies |
| Zdroj: | Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 10(3) |
| ISSN: | 1556-1380 |
| Popis: | Introduction Use of postoperative radiotherapy (PORT) in non–small-cell lung cancer remains controversial. Limited data indicate that PORT may benefit patients with involved N2 nodes. This study evaluates this hypothesis in a large retrospective cohort treated with chemotherapy and contemporary radiation techniques. Methods The National Cancer Data Base was queried for patients diagnosed 2004–2006 with resected non–small-cell lung cancer and pathologically involved N2 (pN2) nodes also treated with chemotherapy. Multivariable Cox proportional hazards model was used to assess factors associated with overall survival (OS). Inverse probability of treatment weighting (IPTW) using the propensity score was used to reduce selection bias. OS was compared between patients treated with versus without PORT using the adjusted Kaplan–Meier estimator and weighted log-rank test based on IPTW. Results Two thousand and one hundred and fifteen patients were eligible for analysis. 918 (43.4%) received PORT, 1197 (56.6%) did not. PORT was associated with better OS (median survival time 42 months with PORT versus 38 months without, p = 0.048). This effect was significant in multivariable and IPTW Cox models (hazard ratio: 0.87, 95% confidence interval: 0.78–0.98, p = 0.026, and hazard ratio: 0.89, 95% confidence interval: 0.79–1.00, p = 0.046, respectively). No interaction was seen between the effects of PORT and number of involved lymph nodes ( p = 0.615). Conclusions PORT was associated with better survival for patients with pN2 nodes also treated with chemotherapy. No interaction was seen between benefit of PORT and number of involved nodes. These findings reinforce the benefit of PORT for N2 disease in modern practice using the largest, most recent cohort of chemotherapy-treated pN2 patients to date. |
| Databáze: | OpenAIRE |
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