Adjuvant Chemotherapy for T3 Non-Small Cell Lung Cancer with Additional Tumor Nodules in the Same Lobe
Adjuvant Chemotherapy for T3 Non-Small Cell Lung Cancer with Additional Tumor Nodules in the Same Lobe
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DOI：
10.1016/j.jtho.2016.03.009
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发表时间：
2016-07-01
影响因子：
20.4
通讯作者：
Boffa, Daniel J.
中科院分区：
文献类型：
--
作者：
Salazar, Michelle C.;Rosen, Joshua E.;Boffa, Daniel J.
简介：非小细胞肺癌手术切除后的辅助化疗在几种分期方案中与生存优势相关。T3肿瘤伴同一肺叶内的单独肿瘤结节（以前称为“卫星结节”）具有显著的全身衰竭风险，但辅助化疗在这种情况下的疗效尚不清楚。T3肿瘤和额外的肿瘤结节在同一叶治疗和术后化疗的患者的生存率进行了评估，以了解辅助化疗在这种setting.Methods的作用：国家癌症数据库查询T3肿瘤与额外的肿瘤结节在同一叶2010年和2012年之间。主要结果为3年总体和相对生存率（癌症特异性生存率的替代指标）。结果：共有1013例T3肿瘤患者和同一肺叶的其他肿瘤结节被确定; 56%接受多药术后化疗，44%仅接受手术切除治疗。与单纯切除术相比，辅助化疗的使用与3年总生存率的提高相关（70%对59%，p < 0.001）。调整患者、肿瘤和治疗因素的考克斯模型表明，与单纯切除术相比，辅助化疗与生存优势相关（风险比= 0.544，p < 0.0001）。辅助化疗亚组的相对3年生存率也有所提高（74%对64%的手术亚组）。结论：辅助化疗与T3肿瘤患者的总生存率增加额外的肺结节。进一步的研究是必要的，以澄清辅助化疗在这种情况下的作用。(C)2016年国际肺癌研究协会。爱思唯尔公司出版All rights reserved.
Introduction: Adjuvant chemotherapy after surgical resection of non-small cell lung cancer is associated with a survival advantage in several staging scenarios. T3 tumors associated with a separate tumor nodule in the same lobe (formerly "satellite nodules") have a significant risk for systemic failure, yet the efficacy of adjuvant chemotherapy in this setting is unknown. The survival of patients with T3 tumors and additional tumor nodules in the same lobe treated with and without postoperative chemotherapy was evaluated to understand the role of adjuvant chemotherapy in this setting.Methods: The National Cancer Data Base was queried for patients with T3 tumors with additional tumor nodules in the same lobe between 2010 and 2012. Primary outcomes were 3-year overall and relative survival (a surrogate of cancer-specific survival).Results: A total of 1013 patients with T3 tumors and additional tumor nodules in the same lobe were identified; 56% received multiagent postoperative chemotherapy and 44% were treated with surgical resection only. The use of adjuvant chemotherapy versus resection alone was associated with improved 3-year overall survival (70% versus 59%, p < 0.001). A Cox model adjusting for patient, tumor, and treatment factors demonstrated that adjuvant chemotherapy was associated with a survival advantage compared with resection alone (hazard ratio = 0.544, p < 0.0001). Relative 3-year survival was also improved in the adjuvant chemotherapy subgroup (74% versus 64% for the surgery-only subgroup).Conclusions: Adjuvant chemotherapy is associated with increased overall survival among patients with T3 tumors with additional pulmonary nodules. Further study is warranted to clarify the role of adjuvant chemotherapy in this setting. (C) 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.