Erdoğu Volkan, Aksoy Yunus, Sezen Celal Buğra, Doğru Mustafa Vedat, Yıldız Nisa, Cansever Levent, Metin Muzaffer
Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Department of Thoracic Surgery, University of Health Sciences Sakarya Training and Research Hospital, Sakarya, Turkey.
Thorac Res Pract. 2023 Nov 28;25(1):35-41. doi: 10.5152/ThoracResPract.2023.23084.
We compared the survival outcomes of surgery within multimodality treatment regimens with the outcomes of definitive chemoradiation treatments in patients diagnosed with clinical (c) IIIB/N2 non-small cell lung cancer (NSCLC). We investigated whether surgery within multimodality treatment provides a survival advantage at this stage.
Data from 79 patients with cIIIB/N2 between 2009 and 2016 were analyzed retrospectively. While the surgery was performed after neoadjuvant therapy in 51 cases (IIIB/Surgery Group), definitive chemotherapy ± radiotherapy was applied in 28 cases (IIIB/Definitive Group).
In cIIIB/N2 cases, the 5-year overall survival (OS) was 27.4%, with a median OS of 24.6 months. The 5-year OS of the IIIB/ Surgery Group was 27.3% (median survival 22.5 months), while it was 28.6% (median survival 29.1 months) in the IIIB/Definitive Group (P = .387, HR = 0.798, 95% CI, 0.485-1.313). Although there was a survival advantage in the group with a pathological complete response (PCR) after surgery (n = 14) compared to the group that did not (n = 37), the observed difference was not statistically significant. (5-year OS; 42.9% vs. 18.5%, P = .104). Additionally, there was no statistically significant difference between the survival of PCR patients and the IIIB/Definitive Group in terms of OS (P = .488).
Surgery performed within multimodality treatment regimens in selected cIIIB/N2 cases did not provide a survival advantage over definitive chemoradiation treatments.
我们比较了多模式治疗方案中的手术治疗与确诊为临床（c）IIIB/N2期非小细胞肺癌（NSCLC）患者的确定性放化疗治疗结果。我们研究了多模式治疗中的手术在该阶段是否能提供生存优势。
回顾性分析了2009年至2016年间79例cIIIB/N2期患者的数据。51例患者在新辅助治疗后进行了手术（IIIB/手术组），28例患者接受了确定性化疗±放疗（IIIB/确定性治疗组）。
在cIIIB/N2期病例中，5年总生存率（OS）为27.4%，中位总生存期为24.6个月。IIIB/手术组的5年总生存率为27.3%（中位生存期22.5个月），而IIIB/确定性治疗组为28.6%（中位生存期29.1个月）（P = 0.387，HR = 0.798，95%CI，0.485 - 1.313）。虽然术后病理完全缓解（PCR）组（n = 14）与未达到病理完全缓解组（n = 37）相比有生存优势，但观察到的差异无统计学意义。（5年总生存率；42.9%对18.5%，P = 0.104）。此外，PCR患者与IIIB/确定性治疗组在总生存期方面无统计学显著差异（P = 0.488）。
在选定的cIIIB/N2期病例中，多模式治疗方案中的手术治疗与确定性放化疗治疗相比未提供生存优势。
