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Role of Pneumonectomy in T1–4N2M0 Non-Small Cell Lung Cancer: A Propensity Score Matching Analysis
BACKGROUND: N2 stage disease constitutes approximately 20%–30% of all non-small cell lung cancer (NSCLC). Concurrently, surgery remains the first-choice treatment for patients with N2 NSCLC if feasible. However, the role of pneumonectomy in N2 NSCLC has rarely been investigated and remains controver...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251381/ https://www.ncbi.nlm.nih.gov/pubmed/35795054 http://dx.doi.org/10.3389/fonc.2022.880515 |
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author | Wang, Suyu Wang, Qing Zhu, Wanli Wei, Juan Feng, Di Lv, Xin Liu, Meiyun |
author_facet | Wang, Suyu Wang, Qing Zhu, Wanli Wei, Juan Feng, Di Lv, Xin Liu, Meiyun |
author_sort | Wang, Suyu |
collection | PubMed |
description | BACKGROUND: N2 stage disease constitutes approximately 20%–30% of all non-small cell lung cancer (NSCLC). Concurrently, surgery remains the first-choice treatment for patients with N2 NSCLC if feasible. However, the role of pneumonectomy in N2 NSCLC has rarely been investigated and remains controversial. METHODS: We enrolled 26,798 patients with T1–4N2M0 NSCLC (stage IIIA/IIIB) from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. We compared the overall survival (OS) and cancer-specific survival (CSS) between patients who received pneumonectomy and those who did not receive surgery. The Kaplan–Meier method, Cox regression analyses, and propensity score matching (PSM) were applied to demonstrate the effect of pneumonectomy. RESULTS: Patients receiving pneumonectomy had a significantly better OS and CSS than those without pneumonectomy both before [adjusted-HR (95% CI): 0.461 (0.425–0.501) for OS, 0.444 (0.406–0.485) for CSS] and after PSM [adjusted-HR (95% CI): 0.499 (0.445–0.560) for OS, 0.457 (0.405–0.517) for CSS] with all p-values <0.001. Subgroup analysis demonstrated concordant results stratified by demographic or clinicopathological variables. In sensitivity analysis, no significant difference was observed between patients receiving single pneumonectomy and chemoradiotherapy without surgery in OS and CSS both before [unadjusted-HR (95% CI): 1.016 (0.878–1.176) for OS, 0.934 (0.794–1.099) for CSS, p = 0.832] and after PSM [unadjusted-HR (95% CI): 0.988 (0.799–1.222) for OS, 0.938 (0.744–1.182) for CSS] with all p-values >0.4. CONCLUSION: For patients with T1–4N2M0 NSCLC (stage IIIA/IIIB), pneumonectomy is an independent protective factor of OS and should be considered when applicable. |
format | Online Article Text |
id | pubmed-9251381 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92513812022-07-05 Role of Pneumonectomy in T1–4N2M0 Non-Small Cell Lung Cancer: A Propensity Score Matching Analysis Wang, Suyu Wang, Qing Zhu, Wanli Wei, Juan Feng, Di Lv, Xin Liu, Meiyun Front Oncol Oncology BACKGROUND: N2 stage disease constitutes approximately 20%–30% of all non-small cell lung cancer (NSCLC). Concurrently, surgery remains the first-choice treatment for patients with N2 NSCLC if feasible. However, the role of pneumonectomy in N2 NSCLC has rarely been investigated and remains controversial. METHODS: We enrolled 26,798 patients with T1–4N2M0 NSCLC (stage IIIA/IIIB) from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. We compared the overall survival (OS) and cancer-specific survival (CSS) between patients who received pneumonectomy and those who did not receive surgery. The Kaplan–Meier method, Cox regression analyses, and propensity score matching (PSM) were applied to demonstrate the effect of pneumonectomy. RESULTS: Patients receiving pneumonectomy had a significantly better OS and CSS than those without pneumonectomy both before [adjusted-HR (95% CI): 0.461 (0.425–0.501) for OS, 0.444 (0.406–0.485) for CSS] and after PSM [adjusted-HR (95% CI): 0.499 (0.445–0.560) for OS, 0.457 (0.405–0.517) for CSS] with all p-values <0.001. Subgroup analysis demonstrated concordant results stratified by demographic or clinicopathological variables. In sensitivity analysis, no significant difference was observed between patients receiving single pneumonectomy and chemoradiotherapy without surgery in OS and CSS both before [unadjusted-HR (95% CI): 1.016 (0.878–1.176) for OS, 0.934 (0.794–1.099) for CSS, p = 0.832] and after PSM [unadjusted-HR (95% CI): 0.988 (0.799–1.222) for OS, 0.938 (0.744–1.182) for CSS] with all p-values >0.4. CONCLUSION: For patients with T1–4N2M0 NSCLC (stage IIIA/IIIB), pneumonectomy is an independent protective factor of OS and should be considered when applicable. Frontiers Media S.A. 2022-06-20 /pmc/articles/PMC9251381/ /pubmed/35795054 http://dx.doi.org/10.3389/fonc.2022.880515 Text en Copyright © 2022 Wang, Wang, Zhu, Wei, Feng, Lv and Liu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Wang, Suyu Wang, Qing Zhu, Wanli Wei, Juan Feng, Di Lv, Xin Liu, Meiyun Role of Pneumonectomy in T1–4N2M0 Non-Small Cell Lung Cancer: A Propensity Score Matching Analysis |
title | Role of Pneumonectomy in T1–4N2M0 Non-Small Cell Lung Cancer: A Propensity Score Matching Analysis |
title_full | Role of Pneumonectomy in T1–4N2M0 Non-Small Cell Lung Cancer: A Propensity Score Matching Analysis |
title_fullStr | Role of Pneumonectomy in T1–4N2M0 Non-Small Cell Lung Cancer: A Propensity Score Matching Analysis |
title_full_unstemmed | Role of Pneumonectomy in T1–4N2M0 Non-Small Cell Lung Cancer: A Propensity Score Matching Analysis |
title_short | Role of Pneumonectomy in T1–4N2M0 Non-Small Cell Lung Cancer: A Propensity Score Matching Analysis |
title_sort | role of pneumonectomy in t1–4n2m0 non-small cell lung cancer: a propensity score matching analysis |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251381/ https://www.ncbi.nlm.nih.gov/pubmed/35795054 http://dx.doi.org/10.3389/fonc.2022.880515 |
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