Lobectomy with Lymph Node Dissection Benefits N3 Stage Non-Small Cell Lung Cancer Patients: A Population-Based Study.

IF 2.5 3区医学 Q3 ONCOLOGY Oncology Pub Date : 2024-09-30 DOI:10.1159/000541634

Zhoujunyi Tian, Jin Zhang, Deruo Liu, Chaoyang Liang

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Abstract

Introduction: There remain controversies about the role of surgery for N3 stage non-small cell lung cancer (NSCLC) patients.

Methods: N3 stage NSCLC patients were identified from the US National Cancer Institute Surveillance, Epidemiology, and End Results database (2010-2020). Survival analysis and multivariate regression models were used to adjust covariates and analyze factors associated with survival. Propensity score matching was used to balance selection bias.

Results: Of 6,473 included patients, 121 received treatment that included lobectomy with mediastinal lymph node dissection. Overall survival (OS) was significantly prolonged in the lobectomy group than in the nonsurgery group (median survival time [MST]: 57 vs. 16 months; log-rank p < 0.001). A total of 403 patients were matched, and OS was significant longer in the lobectomy group (MST: 51 vs. 16 months; log-rank p < 0.001). Multivariate regression analyses indicated that lobectomy was independently associated with improved OS (hazard ratio [HR] 0.398, 95% confidence interval [CI] 0.302-0.526; p < 0.001) and lung cancer-specific death (LCSD) (subhazard ratio [SHR] 0.343, 95% CI: 0.249-0.474; p < 0.001).

Conclusion: Compared with nonsurgical treatment modalities, lobectomy with lymph node dissection was associated with improved OS and LCSD in selected N3 stage NSCLC patients.

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淋巴结清扫的肺叶切除术对 N3 期非小细胞肺癌患者有益：一项基于人群的研究。

导言关于N3期非小细胞肺癌（NSCLC）患者手术治疗的作用仍存在争议：方法：从美国国家癌症研究所监测、流行病学和最终结果数据库（2010-2020年）中识别N3期NSCLC患者。采用生存分析和多变量回归模型调整协变量并分析与生存相关的因素。采用倾向评分匹配来平衡选择偏倚：在6473名纳入患者中，121人接受了包括纵隔淋巴结清扫的肺叶切除术在内的治疗。肺叶切除术组的总生存期（OS）明显长于非手术组[中位生存时间（MST）：57 个月 vs 16 个月；Log-rank p<0.001]。共有 403 名患者进行了配对，肺叶切除术组的 OS 显著延长（中位生存时间：51 个月 vs 16 个月；Log-rank p<0.001）。多变量回归分析表明，肺叶切除术与OS改善[危险比（HR）0.398，95%置信区间（CI）0.302-0.526；p<0.001]和肺癌特异性死亡（LCSD）[亚危险比（SHR）0.343，95%CI 0.249-0.474；p<0.001]独立相关：结论：与非手术治疗方式相比，在选定的N3期NSCLC患者中，肺叶切除加淋巴结清扫与OS和LCSD的改善相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.