Predictive Value of Clinicopathological Factors to Guide Post-Operative Radiotherapy in Completely Resected pN2-Stage III Non-Small Cell Lung Cancer

• DOI: 10.3390/diagnostics13193095
• Publication Date: 2023-09-29T13:39:32Z
• Authors: Ju-Chun Chien; Yu-Chang Hu; Yi-Ju Tsai; Yu-Ting Chien; I-Jung Feng; Yow-Ling Shiue
• Keywords: Lymphovascular invasion; Primary tumor

Introduction: With the evolution of radiotherapy techniques and a better understanding clinicopathological factors, we aimed to evaluate treatment effect post-operative (PORT) associated predictive factors in patients with completely resected pN2 stage III non-small cell lung cancer (R0 pN2-stage NSCLC). Material Method: The registration database single medical center was searched for R0 NSCLC. Clinicopathological information about therapies, including PORT adjuvant systemic treatment, were retrospectively collected analyzed. Kaplan-Meier method Cox regression model applied time-to-event analysis, disease-free survival (DFS) being primary outcome. Results: From 2010 2021, 82 NSCLC evaluated, 70.1% tumors harboring epidermal growth factor receptor mutations (EGFR mut.). performed 73.2% cases, median dose 54 Gy. After follow-up 42 months, 3-year DFS overall (OS) rates 40.6% 77.3%, respectively. Distant metastasis (DM) main failure pattern. In cohort, improved (3-year DFS: 44.9% vs. 29.8%; HR: 0.552, p = 0.045). Positive benefit, EGFR mut., negative extranodal extension, positive lymphovascular invasion, 1-3 lymph nodes, positive-to-dissected node ratio ≤0.22, recognized. OS improvement also observed subgroups less burden. Conclusions: For NSCLC, prolongs selected patients. Further studies on development nomograms guiding application are highly warranted, aiming enhance personalization treatment.