Operative versus Nonoperative Treatment in Patients with Advanced Non-Small-Cell Lung Cancer: Recommended for Surgery
Background. There is currently limited evidence for a correlation between the recommended operation and overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC). Methods. NSCLC patients with stages III and IV, recommended for operation, were identified in the US National Ca...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2023/4119541 |
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| _version_ | 1832551155125714944 |
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| author | Hui Wang Di Yang Yan Lv Jing Lin Haibin Wang |
| author_facet | Hui Wang Di Yang Yan Lv Jing Lin Haibin Wang |
| author_sort | Hui Wang |
| collection | DOAJ |
| description | Background. There is currently limited evidence for a correlation between the recommended operation and overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC). Methods. NSCLC patients with stages III and IV, recommended for operation, were identified in the US National Cancer Institute Surveillance, Epidemiology, and End Results database (SEER).We used propensity score matching (PSM) and multivariable Cox proportional hazards regression to ensure the robustness of our findings. The cumulative rates of death were compared between patients with and without recommended operations using the Kaplan−Meier curves. Results. Operation was recommended for 3331 patients but was not performed in 912 (27.4%) patients (then on-operative group). After PSM, 553 pairs matched. Compared to the nonoperative group, the hazard ratios (HRs) in the operative group were 0.46 (95% CI 0.23–0.95 and p=0.037) in stage IIIA and 0.54 (95% CI 0.42–0.68 and p<0.001) in stage IVA. However, in stages IIIB, IIIC, and IVB, the recommended operative group was not associated with better OS. The OS was not different in stage IIIA-N2, stage IVA-N1, and stage IVA-N3 patients between groups (p=0.28, p=0.14, and p=0.79, respectively). Moreover, the recommended operative group had better OS than the nonoperative group in stage IIIA-N0 (p=0.00085), stage IIIA-N1 (p=0.009), stage IVA-N0 (p<0.001), and stage IVA-N2 (p=0.034). Conclusion. Compared to the nonoperative group, recommended operation improved survival in NSCLC patients with stage IIIA-N0, stage IIIA-N1, stage IVA-N0, and stage IVA-N2. However, in stages IIIA-N2, IIIB, IIIC, IVA-N1, IVA-N3, and IVB, recommended operation did not lead to significantly improved survival time. |
| format | Article |
| id | doaj-art-ed97977634004638bad8aab8b322ec14 |
| institution | Kabale University |
| issn | 1916-7245 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-ed97977634004638bad8aab8b322ec142025-02-03T06:04:51ZengWileyCanadian Respiratory Journal1916-72452023-01-01202310.1155/2023/4119541Operative versus Nonoperative Treatment in Patients with Advanced Non-Small-Cell Lung Cancer: Recommended for SurgeryHui Wang0Di Yang1Yan Lv2Jing Lin3Haibin Wang4Department of Clinical LaboratoryDepartment of Orthopedics SurgeryDepartment of Respiratory and Critical Care MedicineDepartment of Clinical LaboratoryDepartment of Clinical LaboratoryBackground. There is currently limited evidence for a correlation between the recommended operation and overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC). Methods. NSCLC patients with stages III and IV, recommended for operation, were identified in the US National Cancer Institute Surveillance, Epidemiology, and End Results database (SEER).We used propensity score matching (PSM) and multivariable Cox proportional hazards regression to ensure the robustness of our findings. The cumulative rates of death were compared between patients with and without recommended operations using the Kaplan−Meier curves. Results. Operation was recommended for 3331 patients but was not performed in 912 (27.4%) patients (then on-operative group). After PSM, 553 pairs matched. Compared to the nonoperative group, the hazard ratios (HRs) in the operative group were 0.46 (95% CI 0.23–0.95 and p=0.037) in stage IIIA and 0.54 (95% CI 0.42–0.68 and p<0.001) in stage IVA. However, in stages IIIB, IIIC, and IVB, the recommended operative group was not associated with better OS. The OS was not different in stage IIIA-N2, stage IVA-N1, and stage IVA-N3 patients between groups (p=0.28, p=0.14, and p=0.79, respectively). Moreover, the recommended operative group had better OS than the nonoperative group in stage IIIA-N0 (p=0.00085), stage IIIA-N1 (p=0.009), stage IVA-N0 (p<0.001), and stage IVA-N2 (p=0.034). Conclusion. Compared to the nonoperative group, recommended operation improved survival in NSCLC patients with stage IIIA-N0, stage IIIA-N1, stage IVA-N0, and stage IVA-N2. However, in stages IIIA-N2, IIIB, IIIC, IVA-N1, IVA-N3, and IVB, recommended operation did not lead to significantly improved survival time.http://dx.doi.org/10.1155/2023/4119541 |
| spellingShingle | Hui Wang Di Yang Yan Lv Jing Lin Haibin Wang Operative versus Nonoperative Treatment in Patients with Advanced Non-Small-Cell Lung Cancer: Recommended for Surgery Canadian Respiratory Journal |
| title | Operative versus Nonoperative Treatment in Patients with Advanced Non-Small-Cell Lung Cancer: Recommended for Surgery |
| title_full | Operative versus Nonoperative Treatment in Patients with Advanced Non-Small-Cell Lung Cancer: Recommended for Surgery |
| title_fullStr | Operative versus Nonoperative Treatment in Patients with Advanced Non-Small-Cell Lung Cancer: Recommended for Surgery |
| title_full_unstemmed | Operative versus Nonoperative Treatment in Patients with Advanced Non-Small-Cell Lung Cancer: Recommended for Surgery |
| title_short | Operative versus Nonoperative Treatment in Patients with Advanced Non-Small-Cell Lung Cancer: Recommended for Surgery |
| title_sort | operative versus nonoperative treatment in patients with advanced non small cell lung cancer recommended for surgery |
| url | http://dx.doi.org/10.1155/2023/4119541 |
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