Department of Thoracic Surgery, Peking Union Medical college Hospital, Chinese Academy of Medical Science & Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
BMC Surg. 2024 May 8;24(1):140. doi: 10.1186/s12893-024-02428-w.
We investigated the real-world efficacy of adjuvant therapy for stage I lung adenocarcinoma patients with pathological high-risk factors.
Study participants were enrolled from November 1, 2016 and December 31, 2020. Clinical bias was balanced by propensity score matching. Disease-free survival (DFS) outcomes were compared by Kaplan-Meier analysis. The Cox proportional hazards regression was used to identify survival-associated factors. p ≤ 0.05 was the threshold for statistical significance.
A total of 454 patients, among whom 134 (29.5%) underwent adjuvant therapy, were enrolled in this study. One hundred and eighteen of the patients who underwent adjuvant therapy were well matched with non-treatment patients. Prognostic outcomes of the treatment group were significantly better than those of the non-treatment group, as revealed by Kaplan-Meier analysis after PSM. Differences in prevention of recurrence or metastasis between the targeted therapy and chemotherapy groups were insignificant. Adjuvant therapy was found to be positive prognostic factors, tumor size and solid growth patterns were negative.
Adjuvant therapy significantly improved the DFS for stage I lung adenocarcinoma patients with high-risk factors. Larger prospective clinical trials should be performed to verify our findings.
我们研究了具有病理高危因素的 I 期肺腺癌患者辅助治疗的真实世界疗效。
研究参与者于 2016 年 11 月 1 日至 2020 年 12 月 31 日入组。通过倾向性评分匹配平衡临床偏倚。通过 Kaplan-Meier 分析比较无病生存（DFS）结果。使用 Cox 比例风险回归确定与生存相关的因素。p≤0.05 为统计学意义的阈值。
本研究共纳入 454 例患者，其中 134 例（29.5%）接受了辅助治疗。接受辅助治疗的 118 例患者与未治疗患者进行了很好的匹配。Kaplan-Meier 分析显示，PSM 后治疗组的预后明显优于未治疗组。靶向治疗与化疗组在预防复发或转移方面差异无统计学意义。辅助治疗是阳性预后因素，肿瘤大小和实体生长模式是阴性预后因素。
辅助治疗显著改善了具有高危因素的 I 期肺腺癌患者的 DFS。应开展更大规模的前瞻性临床试验来验证我们的发现。
