Prognostic factors of T2aN0M0 (T3-4cmN0M0, stage IB) non-small-cell lung cancer after surgery: Single-center real-world research

Thorac Cancer. 2021 Dec;12(24):3319-3326. doi: 10.1111/1759-7714.14204. Epub 2021 Nov 3.

Abstract

Aim: To further elucidate the prognostic factors of non-small-cell lung cancer (NSCLC) patients with T2aN0M0 (stage IB) who underwent surgical treatment.

Methods: We retrospectively analyzed the data of stage IB NSCLC patients who underwent surgical treatment at our center from October 2013 to September 2016. Eighty patients were enrolled. We analyzed their overall survival (OS) and disease-free survival (DFS) using the Kaplan-Meier method.

Results: In univariable analysis, adenosquamous carcinoma (ASC) was significantly associated with inferior DFS (p = 0.036, p = 0.037) and OS (p = 0.001, p = 0.003) in all stage IB patients and those who only accepted surgery. Patients with a number of N2 lymph node dissections of ≥3 regions (N2-LSNDr) exhibited better DFS (p = 0.020, p = 0.005) and OS (p = 0.003, p = 0.001) in all stage IB patients and those who only accepted surgery. In addition, advanced age (≥70 years old) is an adverse factor for DFS (p = 0.049) and OS (p = 0.018) among patients who did not receive adjuvant chemotherapy following surgery. In multivariable analyses, patients with N2-LSNDr exhibited a longer OS (p = 0.045) in all enrolled patients; patients with N2-LSNDr (p = 0.016) and younger age (p = 0.021) demonstrated a superior OS in patients who only received surgery.

Conclusions: We found that N2-LSNDr were independent influencing factors affecting the prognosis in all included stage IB patients and stage IB patients without adjuvant chemotherapy. ASC was associated with worse prognosis of T2aN0M0 NSCLC. Older age is an independent prognostic factor of the worst OS in stage IB patients without adjuvant chemotherapy.

Keywords: IB stage; non-small-lung cancer; prognosis; surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery*
  • Lymph Node Excision / methods
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Pneumonectomy / methods
  • Prognosis
  • Retrospective Studies