Choice of Treatment for Patients With Non–small-cell Lung Cancer >5 cm Between Surgery Alone and Surgery Plus Adjuvant Radiotherapy

Bibliographic Details
Title: Choice of Treatment for Patients With Non–small-cell Lung Cancer >5 cm Between Surgery Alone and Surgery Plus Adjuvant Radiotherapy
Authors: Boyan Wang, Yongjie Zhou, Min Jia, Zhiping Yan, Jiayan Chen, Xueguan Lu, Ruiyan Wu, Junmiao Wen
Source: Frontiers in Surgery, Vol 8 (2021)
Publisher Information: Frontiers Media S.A., 2021.
Publication Year: 2021
Collection: LCC:Surgery
Subject Terms: NSCLC, surgery, postoperative radiotherapy, node-negative, T-stage, Surgery, RD1-811
More Details: Background: According to the lung cancer staging project, T2b (>5–7 cm) and T3 (>7 cm) non-small cell lung cancers (NSCLC) should be reclassified into T3 and T4 groups. The objective of this study was to evaluate the effect of surgery alone or surgery plus adjuvant radiation (SART) on survival of node-negative patients with NSCLC >5 cm.Methods: We identified 4557 N0 patients with NSCLC >5 cm in the Surveillance, Epidemiology, and End Results database from 2004 to 2014. Overall survival (OS) and cancer–specific survival (CSS) were compared among patients who underwent surgery alone and SART. The proportional hazards model was applied to evaluate multiple prognostic factors.Results: 1,042 and 525 patients who underwent surgery alone and SART, respectively were enrolled after propensity-score matching. OS and CSS favored surgery alone rather than SART. Multivariate analysis showed that the number of lymph nodes examined more than six was associated with better OS and CSS for NSCLC >5 cm, especially in patients treated with surgery alone. Lobectomy should be recommended as the primary option for NSCLC >5 to 7 cm, whereas its superiority was not significant over sublobectomy for NSCLC >7 cm.Conclusion: Surgery alone should be recommended as the first choice for patients with NSCLC >5 cm. The number of examined lymph nodes should be more than six in patients with NSCLC >5 cm, especially for those who undergo surgery alone. For patients with NSCLC >7 cm who could not tolerate lobectomy, sublobectomy might be an alternative surgical procedure.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2296-875X
Relation: https://www.frontiersin.org/articles/10.3389/fsurg.2021.649802/full; https://doaj.org/toc/2296-875X
DOI: 10.3389/fsurg.2021.649802
Access URL: https://doaj.org/article/1882fec5300d47d1a0c1faaefaa2f602
Accession Number: edsdoj.1882fec5300d47d1a0c1faaefaa2f602
Database: Directory of Open Access Journals
More Details
ISSN:2296875X
DOI:10.3389/fsurg.2021.649802
Published in:Frontiers in Surgery
Language:English