Postoperative radiotherapy improves survival in completely resected non-small cell lung cancer with pathologic N2 stage IIIA and positive lymph node count greater than one: a SEER-based retrospective cohort study
ObjectiveNon-small cell lung cancer (NSCLC) constitutes approximately 85% of lung cancer cases, with 20%–30% of patients diagnosed at stage III. While multimodal therapy is the standard for treating locally advanced NSCLC, the role of PORT remains controversial. This study seeks to evaluate the effe...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2024.1506854/full |
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| author | Diyang Zhu Yuanyuan Xiao Yuanyuan Xiao Shancheng He Shancheng He Baochang Xie Baochang Xie Wenqi Zhao Wenqi Zhao Yuhui Xu |
| author_facet | Diyang Zhu Yuanyuan Xiao Yuanyuan Xiao Shancheng He Shancheng He Baochang Xie Baochang Xie Wenqi Zhao Wenqi Zhao Yuhui Xu |
| author_sort | Diyang Zhu |
| collection | DOAJ |
| description | ObjectiveNon-small cell lung cancer (NSCLC) constitutes approximately 85% of lung cancer cases, with 20%–30% of patients diagnosed at stage III. While multimodal therapy is the standard for treating locally advanced NSCLC, the role of PORT remains controversial. This study seeks to evaluate the effect of postoperative radiotherapy (PORT) on overall survival (OS) and cancer-specific survival (CSS) in patients with resected pathologic N2 (pN2) stage IIIA NSCLC.MethodsData from the Surveillance, Epidemiology, and End Results Program (SEER) 17 registry (2010–2019) were analyzed. The cohort included 1,471 patients aged 65 years or older, diagnosed with stage IIIA pN2 NSCLC, who had undergone lobectomy or total pneumonectomy. Patients who had received neoadjuvant chemotherapy or radiotherapy were excluded. Univariate and multivariate analyses were conducted to assess the association of PORT with OS and CSS. Kaplan-Meier survival curves were employed to estimate survival outcomes, while the COX proportional hazards model was utilized for comparative analysis. PLN counts were stratified into two categories: ≤1 and >1.ResultsAmong the 1,471 patients included in the study, 613 (41.67%) received PORT, while 858 (58.33%) did not. PORT was associated with a significantly higher 1- and 3-year OS (89.96% and 68.49%, respectively) compared to the non-PORT group (87.44% and 61.88%, respectively, P = 0.03). However, no significant difference in CSS was observed between the groups (P = 0.15). Among patients with PLN counts >1, PORT significantly improved OS (HR = 1.32, 95% CI = 1.04–1.68, P = 0.0016) and CSS (HR = 1.32, 95% CI = 0.99–1.70, P = 0.026), whereas no significant differences were seen in patients with PLN counts ≤1.ConclusionsThis study underscores the potential of PORT in enhancing OS in patients with resectable pN2 stage IIIA NSCLC, particularly in those with PLN counts exceeding one. These findings suggest that PORT may offer improved outcomes in patients with extensive lymph node involvement, emphasizing the need for further prospective studies to validate and expand upon these observations. |
| format | Article |
| id | doaj-art-9203bf0b16064d20a48b8b1c2cf799cf |
| institution | Kabale University |
| issn | 2296-875X |
| language | English |
| publishDate | 2025-02-01 |
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| series | Frontiers in Surgery |
| spelling | doaj-art-9203bf0b16064d20a48b8b1c2cf799cf2025-02-04T06:31:57ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-02-011110.3389/fsurg.2024.15068541506854Postoperative radiotherapy improves survival in completely resected non-small cell lung cancer with pathologic N2 stage IIIA and positive lymph node count greater than one: a SEER-based retrospective cohort studyDiyang Zhu0Yuanyuan Xiao1Yuanyuan Xiao2Shancheng He3Shancheng He4Baochang Xie5Baochang Xie6Wenqi Zhao7Wenqi Zhao8Yuhui Xu9Department of Internal Medicine, The Second People’s Hospital of Yudu County, Ganzhou City, Jiangxi Province, ChinaDepartment of Critical Care Medicine, Ganzhou Fifth People’s Hospital, Ganzhou, ChinaDepartment of Critical Care Medicine, Ganzhou Respiratory Disease Control Institute, Ganzhou, ChinaDepartment of Critical Care Medicine, Ganzhou Fifth People’s Hospital, Ganzhou, ChinaDepartment of Critical Care Medicine, Ganzhou Respiratory Disease Control Institute, Ganzhou, ChinaDepartment of Critical Care Medicine, Ganzhou Fifth People’s Hospital, Ganzhou, ChinaDepartment of Critical Care Medicine, Ganzhou Respiratory Disease Control Institute, Ganzhou, ChinaDepartment of Critical Care Medicine, Ganzhou Fifth People’s Hospital, Ganzhou, ChinaDepartment of Critical Care Medicine, Ganzhou Respiratory Disease Control Institute, Ganzhou, ChinaDepartment of Pulmonary and Critical Care Medicine, Ganzhou People’s Hospital, Ganzhou, Jiangxi, ChinaObjectiveNon-small cell lung cancer (NSCLC) constitutes approximately 85% of lung cancer cases, with 20%–30% of patients diagnosed at stage III. While multimodal therapy is the standard for treating locally advanced NSCLC, the role of PORT remains controversial. This study seeks to evaluate the effect of postoperative radiotherapy (PORT) on overall survival (OS) and cancer-specific survival (CSS) in patients with resected pathologic N2 (pN2) stage IIIA NSCLC.MethodsData from the Surveillance, Epidemiology, and End Results Program (SEER) 17 registry (2010–2019) were analyzed. The cohort included 1,471 patients aged 65 years or older, diagnosed with stage IIIA pN2 NSCLC, who had undergone lobectomy or total pneumonectomy. Patients who had received neoadjuvant chemotherapy or radiotherapy were excluded. Univariate and multivariate analyses were conducted to assess the association of PORT with OS and CSS. Kaplan-Meier survival curves were employed to estimate survival outcomes, while the COX proportional hazards model was utilized for comparative analysis. PLN counts were stratified into two categories: ≤1 and >1.ResultsAmong the 1,471 patients included in the study, 613 (41.67%) received PORT, while 858 (58.33%) did not. PORT was associated with a significantly higher 1- and 3-year OS (89.96% and 68.49%, respectively) compared to the non-PORT group (87.44% and 61.88%, respectively, P = 0.03). However, no significant difference in CSS was observed between the groups (P = 0.15). Among patients with PLN counts >1, PORT significantly improved OS (HR = 1.32, 95% CI = 1.04–1.68, P = 0.0016) and CSS (HR = 1.32, 95% CI = 0.99–1.70, P = 0.026), whereas no significant differences were seen in patients with PLN counts ≤1.ConclusionsThis study underscores the potential of PORT in enhancing OS in patients with resectable pN2 stage IIIA NSCLC, particularly in those with PLN counts exceeding one. These findings suggest that PORT may offer improved outcomes in patients with extensive lymph node involvement, emphasizing the need for further prospective studies to validate and expand upon these observations.https://www.frontiersin.org/articles/10.3389/fsurg.2024.1506854/fullnon-small cell lung cancerpostoperative radiotherapyoverall survivalpositive lymph nodesstage IIIA pathologic N2 |
| spellingShingle | Diyang Zhu Yuanyuan Xiao Yuanyuan Xiao Shancheng He Shancheng He Baochang Xie Baochang Xie Wenqi Zhao Wenqi Zhao Yuhui Xu Postoperative radiotherapy improves survival in completely resected non-small cell lung cancer with pathologic N2 stage IIIA and positive lymph node count greater than one: a SEER-based retrospective cohort study Frontiers in Surgery non-small cell lung cancer postoperative radiotherapy overall survival positive lymph nodes stage IIIA pathologic N2 |
| title | Postoperative radiotherapy improves survival in completely resected non-small cell lung cancer with pathologic N2 stage IIIA and positive lymph node count greater than one: a SEER-based retrospective cohort study |
| title_full | Postoperative radiotherapy improves survival in completely resected non-small cell lung cancer with pathologic N2 stage IIIA and positive lymph node count greater than one: a SEER-based retrospective cohort study |
| title_fullStr | Postoperative radiotherapy improves survival in completely resected non-small cell lung cancer with pathologic N2 stage IIIA and positive lymph node count greater than one: a SEER-based retrospective cohort study |
| title_full_unstemmed | Postoperative radiotherapy improves survival in completely resected non-small cell lung cancer with pathologic N2 stage IIIA and positive lymph node count greater than one: a SEER-based retrospective cohort study |
| title_short | Postoperative radiotherapy improves survival in completely resected non-small cell lung cancer with pathologic N2 stage IIIA and positive lymph node count greater than one: a SEER-based retrospective cohort study |
| title_sort | postoperative radiotherapy improves survival in completely resected non small cell lung cancer with pathologic n2 stage iiia and positive lymph node count greater than one a seer based retrospective cohort study |
| topic | non-small cell lung cancer postoperative radiotherapy overall survival positive lymph nodes stage IIIA pathologic N2 |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2024.1506854/full |
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