Comparison of recurrence risk between patients with clinically node‐positive and ‐negative stage I non‐small cell lung cancer following surgery: A propensity score matching analysis

Thoracic Cancer

Sheng‐Hao Lin¹  Ching‐Hsiung Lin¹  Kuo‐Yang Huang¹  Hung‐Jen Chen²  Ching‐Yuan Cheng³  Bing‐Yen Wang⁴ 

[1] Division of Chest Medicine, Department of Internal Medicine Changhua Christian Hospital Changhua Taiwan;Division of Pulmonary and Critical Care, Department of Internal Medicine China Medical University Hospital Taichung Taiwan;Division of Thoracic Surgery, Department of Surgery Changhua Christian Hospital Changhua Taiwan;Institute of Genomics and Bioinformatics National Chung Hsing University Taichung Taiwan;

关键词: lymph node metastasis;    non‐small cell lung cancer;    recurrence;    staging;    surgery;   

DOI  :  10.1111/1759-7714.14462

来源: DOAJ

【 摘 要 】

Abstract Background Identifying patients with stage I non‐small cell lung cancer (NSCLC) at increased risk of tumor recurrence following surgery remains a major challenge. The current study aimed to compare disease‐free survival (DFS) rates after surgery between patients with clinically node‐positive (cN+) and ‐negative (cN0) stage I NSCLC. Methods Patients with pathological stage I resected NSCLC were identified from the lung cancer database of Changhua Christian Hospital in Taiwan. Patients with clinical N status 1 or 2 and pathological N status 0 were identified as the cN+/pN0 cohort, whereas others were identified as the cN0/pN0 cohort. Propensity score matching (PSM) was used to balance the baseline characteristics between both cohorts. Kaplan–Meier method and Cox proportional hazards model were used to evaluate DFS. Results From January 2010 to July 2019, 754 eligible patients were enrolled into the study, among whom 41 (5.4%) were cN+/pN0. The median follow‐up time was 43.4 months. Before PSM, the 5‐year DFS rate was 79.0% and 90.3% in cN+/pN0 and cN0/pN0 cohorts (log‐rank test, p = 0.009), respectively. After a 1:4 PSM, multivariate analysis showed that the cN+/pN0 cohort still had a poorer DFS compared to the cN0/pN0 cohort in (hazard ratio, 3.17; p = 0.040). Conclusion Among patients with stage I resected NSCLC, cN+ patients had a worse DFS compared to cN0 patients. Surgeons should therefore consider more aggressive adjuvant therapy or frequent follow‐up in patients with surgically resected stage I NSCLC with cN+ status.

【 授权许可】

Unknown