Turan Oğuzhan, Hasdıraz Leyla, Aslan Sezer, Demir Omer Faruk, Onal Omer, Eroğlu Celalettin
Department of Thoracic Surgery, Kayseri City Training and Research Hospital, Kayseri, Türkiye.
Department of Thoracic Surgery, Erciyes University Faculty of Medicine, Kayseri, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2025 Jun 27;33(3):375-381. doi: 10.5606/tgkdc.dergisi.2025.27574. eCollection 2025 Jul.
In this study, we aimed to compare the outcomes of patients who underwent surgery after neoadjuvant chemoradiotherapy versus primary surgery in locally advanced T4 non-small cell lung cancer.
Between January 2010 and January 2020, a total of 71 non-small cell lung cancer patients (63 males, 8 females; mean age: 57.9±9.6 years; range, 34 to 76 years) diagnosed with T4 tumors and underwent surgery were retrospectively analyzed. Of these patients, 50 underwent neoadjuvant therapy before surgical resection (Group 1), while 21 underwent surgical resection alone (Group 2). Demographic characteristics, complications, mortality and pathological examination results of the patients were recorded.
The neoadjuvant therapy group exhibited a significantly lower mortality rate (odds ratio=4.3). Age and neoadjuvant treatment were the most significant factors on mortality. Overall survival was longer among patients receiving neoadjuvant chemoradiotherapy, but not statistically significant (80.5±9.9 months vs. 60.9±7.9 months, p=0.081).
Our study results indicated a substantial reduction in mortality rates among patients with T4 tumors who underwent concurrent neoadjuvant chemoradiotherapy. Based on these results, neoadjuvant treatment serves as a beneficial preoperative intervention for eligible patients and should be considered before surgical resection.
在本研究中，我们旨在比较局部晚期T4非小细胞肺癌患者在新辅助放化疗后接受手术与直接手术的疗效。
回顾性分析2010年1月至2020年1月期间共71例诊断为T4肿瘤并接受手术的非小细胞肺癌患者（63例男性，8例女性；平均年龄：57.9±9.6岁；范围34至76岁）。其中，50例在手术切除前接受了新辅助治疗（第1组），而21例仅接受了手术切除（第2组）。记录患者的人口统计学特征、并发症、死亡率和病理检查结果。
新辅助治疗组的死亡率显著较低（优势比=4.3）。年龄和新辅助治疗是影响死亡率的最重要因素。接受新辅助放化疗的患者总生存期较长，但无统计学意义（80.5±9.9个月对60.9±7.9个月，p=0.081）。
我们的研究结果表明，接受同步新辅助放化疗的T4肿瘤患者死亡率大幅降低。基于这些结果，新辅助治疗对符合条件的患者是一种有益的术前干预措施，在手术切除前应予以考虑。
