背景:对于II期和III期非小细胞肺癌(NSCLC)患者,需要各种多模态治疗。然而,根据患者的具体情况,预后会有显著差异。因此,本研究使用韩国肺癌注册协会(KALC-R)2014年至2016年的数据,调查了治疗不充分(手术有限和辅助治疗不充分)对II期或III期NSCLC患者的临床影响.
方法:在2014-2016年韩国中央癌症登记处登记的8110例新肺癌病例中,选择721例II期或III期NSCLC患者,根据癌症治疗方法的差异分为三组。在A组中,患者接受标准手术并完成辅助治疗.B组,患者在未完成辅助治疗的情况下接受了标准手术.C组,患者在有限手术后接受辅助治疗.在对选定的患者进行倾向评分匹配(PSM)后,然后比较三组II期和III期NSCLC患者的总生存率(OS)和无病生存率(DFS).
结果:在721例非小细胞肺癌患者中,239、437和45属于A组,B,C,分别。B组和C组1:3PS匹配后,B组和C组II期或III期NSCLC患者的5年生存率分别为68.0%和26.7%,B组和C组的DFS分别为59.1%和16.2%,分别。
结论:标准手术治疗效果最好。尽管患者接受了辅助治疗,与省略辅助治疗后进行标准手术相比,有限切除导致受损患者的预后更差.因此,对于无法完成手术和辅助治疗的患者,应考虑手术治疗。
BACKGROUND: For patients with stage II and III non-small cell lung cancer (NSCLC), various multi-modality treatments are required. However, depending on the individual conditions of patients, there will be a significant difference in prognosis. Therefore, this study investigated the clinical impact of inadequate treatment (limited surgery and inadequate adjuvant therapy) in patients with NSCLC stage II or III using data from the Korean Association of Lung Cancer Registry (KALC-R) between 2014 and 2016.
METHODS: Of the 8,110 new lung cancer cases registered at the Korea Central Cancer Registry in 2014-2016, 721 patients with stage II or III NSCLC were selected and divided into three groups according to differences in cancer treatment methods. In group A, patients underwent standard surgery and completed adjuvant therapy. In group B, patients underwent standard surgery without completing adjuvant therapy. In group C, patients received adjuvant therapy after limited surgery. After performing propensity score matching (PSM) for selected patients, overall survival (OS) and disease-free survival (DFS) rates of the three groups of patients with stage II and III NSCLC patients were then compared.
RESULTS: Of the 721 patients with NSCLC, 239, 437, and 45 belonged to groups A, B, and C, respectively. After 1:3 PS matching for groups B and C, the 5-year survival rate of patients with stage II or III NSCLC were 68.0% and 26.7% for groups B and C, respectively and the DFS rate was 59.1% and 16.2% for groups B and C, respectively.
CONCLUSIONS: The therapeutic effect of the standard surgery was the best. Although patients received adjuvant therapy, limited resection resulted in a poorer prognosis in compromised patients compared with omitting adjuvant therapy followed by standard surgery. Thus, surgical treatment should be considered in patients who are unable to complete surgical and adjuvant therapy.