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Is There a Prognostic Difference Between Stage IIIA Subgroups in Lung Cancer?


Citak, Necati; Guglielmetti, Laura; Aksoy, Yunus; Isgörücü, Ozgür; Metin, Muzaffer; Sayar, Adnan; Opitz, Isabelle; Schneiter, Didier; Weder, Walter; Inci, Ilhan (2020). Is There a Prognostic Difference Between Stage IIIA Subgroups in Lung Cancer? Annals of Thoracic Surgery:Epub ahead of print.

Abstract

BACKGROUND

Treatment of stage IIIA lung cancer remains controversial because it includes a very heterogeneous group of patients. The purpose of our study was to compare survival between stage IIIA-subsets, and to externally validate our results with another center's database.

METHODS

Patients with completely resected stage IIIA/B lung cancer were retrospectively analyzed. There were 424 patients with stage IIIA and 82 patients with stage IIIB (T3/4N2) (study cohort). Stage IIIA was divided into two subsets according to the tumor localization / tumor size (T3N1-T4N0/1, IIIA-T group; n=308) and the extension of nodal disease (T1/2N2, IIIA-N2 group; n=116). According to the study cohort results, a model for stage IIIA patients was created. It was validated with another center's database (validation cohort).

RESULTS

In the multivariate analyses, age, stage IIIB and pN2 were all independent negative prognostic factors (p<0.0001). Five-year survival for patients in the IIIA-T group was 51.3% (median 64 months), whereas it was 25.7% (median 31 months) in the IIIA-N2 patients (HR=1.834, p<0.0001). There was no statistical difference in regard to the survival between the IIIA-N2 and stage IIIB groups (25.7% versus 25.3%, p=0.442). The created model was performed on patients in the validation cohort as a model IIIA-T (T3N1-T4N0/1, n=139), and model IIIA-N2 (T1/2N2, n=104). Model IIIA-T patients had a statistically better survival rate than model IIIA-N2 patients (median 62 months versus 37 months, HR=1.707, p=0.0007).

CONCLUSIONS

There is a prognostic difference between stage IIIA subgroups in lung cancer patients who undergo surgical treatment.

Abstract

BACKGROUND

Treatment of stage IIIA lung cancer remains controversial because it includes a very heterogeneous group of patients. The purpose of our study was to compare survival between stage IIIA-subsets, and to externally validate our results with another center's database.

METHODS

Patients with completely resected stage IIIA/B lung cancer were retrospectively analyzed. There were 424 patients with stage IIIA and 82 patients with stage IIIB (T3/4N2) (study cohort). Stage IIIA was divided into two subsets according to the tumor localization / tumor size (T3N1-T4N0/1, IIIA-T group; n=308) and the extension of nodal disease (T1/2N2, IIIA-N2 group; n=116). According to the study cohort results, a model for stage IIIA patients was created. It was validated with another center's database (validation cohort).

RESULTS

In the multivariate analyses, age, stage IIIB and pN2 were all independent negative prognostic factors (p<0.0001). Five-year survival for patients in the IIIA-T group was 51.3% (median 64 months), whereas it was 25.7% (median 31 months) in the IIIA-N2 patients (HR=1.834, p<0.0001). There was no statistical difference in regard to the survival between the IIIA-N2 and stage IIIB groups (25.7% versus 25.3%, p=0.442). The created model was performed on patients in the validation cohort as a model IIIA-T (T3N1-T4N0/1, n=139), and model IIIA-N2 (T1/2N2, n=104). Model IIIA-T patients had a statistically better survival rate than model IIIA-N2 patients (median 62 months versus 37 months, HR=1.707, p=0.0007).

CONCLUSIONS

There is a prognostic difference between stage IIIA subgroups in lung cancer patients who undergo surgical treatment.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Thoracic Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:26 November 2020
Deposited On:15 Dec 2020 16:14
Last Modified:15 Dec 2020 16:44
Publisher:Elsevier
ISSN:0003-4975
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.athoracsur.2020.10.033
PubMed ID:33248991

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