Postoperative radiotherapy for patients with completely resected pathological stage IIIA-N2 non-small cell lung cancer: a preferential benefit for squamous cell carcinoma

Tian, Cuimeng; Liu, Guimei; Xu, Yongxiang; Xia, Guangrong; Zhang, Tongmei; Huang, Jiaqiang; Jiang, Hui; Ming Wang, Ji; Li, Baolan

doi:10.2478/raon-2020-0070

Figures & Tables

The survival of 194 lung adenocarcinoma (LADC) cases with or without postoperative radiotherapy (PORT). (A) Overall survival (OS) of PORT and non-PORT patients. (B) OS of 85 lung squamous cell carcinoma (LSCC) cases with PORT or non-PORT.

The effect of postoperative radiotherapy (PORT) on the survival of 85 lung squamous cell carcinoma (LSCC) patients. (A) Overall survival (OS). (B) loco-regional recurrence-free survival (LRFS). (C) Distant metastasis-free survival (DMFS). PORT alone was a significant positive prognostic factor for OS (p = 0.017) (A); LRFS (p = 0.006 (B); and DMFS (p = 0.013) (C).

Univariate analyses of the factors affecting overall survival (OS), loco-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) of lung squamous cell carcinoma (LADC) patients (N = 194)

Characteristics	No.	OS		LRFS		DMFS
Characteristics	No.	5-year OS, %	P	5-year LRFS, %	P	5-year DMFS, %	P
Gender			0.071		0.085		0.139
Female	96	48.2		46.9		44.1
Male	98	39.6		37.1		30.6
Age(yr)			0.751		0.811		0.494
< 65	139	43.6		41.6		34.5
≥ 65	55	45.0		42.8		41.3
Smoking Index			0.001*		0.001*		0.006*
< 400	127	50.4		49.4		44.5
≥ 400	67	31.0		27.4		22.7
Types of surgery			0.468		0.158		0.319
Lobectomy	178	44.1		42.3		36.5
Pneumonectomy	16	41.7		38.5		37.5
Pathologic T stage			0.032*		0.020*		0.001*
pT1–2	166	46.3		44.0		40.4
pT3	28	29.5		28.0		15.5
Types of pN2			0.001*		0.002*		0.000*
a1	46	60.9		58.3		58.8
a2	62	37.9		38.8		37.8
b	86	38.7		35.4		22.5
N of positive nodes			0.000*		0.000*		0.000*
1–3	87	56.6		54.7		53.4
≥ 4	107	33.3		31.4		20.4
PLNR			0.000*		0.001*		0.000*
< 20%	80	54.8		52.7		51.8
≥ 20%	114	35.7		34.0		26.9
N of N2 stations			0.001*		0.002*		0.001*
Single	46	60.9		58.3		58.8
Multiple	148	38.3		36.9		29.0
POCT			0.169		0.280		0.541
No	24	34.4		36.5		37.5
Yes	170	44.9		43.0		36.6
PORT			0.948		0.723		0.440
No	152	45.0		43.0		38.8
Yes	42	40.0		40.0		28.7

Multivariate analyses of the factors affecting overall survival (OS), loco-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) of lung adenocarcinoma (LSCC) patients (N = 85)

Characteristics	OS		LRFS		DMFS
Characteristics	HR (95% CI)	P	HR(95% CI)	P	HR (95% CI)	P
Smoking Index		0.789		0.823		0.563
< 400	1		1		1
≥ 400	0.905(0.436–1.880)		0.922(0.454–1.874)		0.806(0.389–1.672)
Pathologic T stage		0.208		0.149		0.151
pT1–2	1		1		1
pT3	1.436(0.817–2.522)		1.524(0.860–2.701)		1.522(0.858–2.699)
N of positive nodes		0.257		0.296		0.664
1–3	1		1		1
≥ 4	1.618(0.704–3.715)		1.556(0.679–3.563)		1.194(0.537–2.657)
PLNR		0.440		0.454		0.330
< 20%	1		1		1
≥ 20%	1.322(0.650–2.689)		1.308(0.648–2.643)		1.428(0.697–2.925)
N of N2 stations		0.922		0.963		0.813
Single	1		1		1
Multiple	1.043(0.447–2.436)		0.979(0.409–2.343)		0.903(0.385–2.114)
POCT		0.127		0.224		0.496
No	1		1		1
Yes	0.523(0.227–1.202)		0.595(0.258–1.374)		0.751(0.328–1.715)
PORT		0.017*		0.006*		0.013*
No	1		1		1
Yes	0.364(0.159–1.832)		0.308(0.133–0.712)		0.349(0.152–0.802)

Univariate analyses of the factors affecting overall survival (OS), loco-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) of lung adenocarcinoma (LSCC) patients (N = 85)

Characteristics	No	OS		LRFS		DMFS
Characteristics	No	5-year OS, %	P	5-year LRFS, %	P	5-year DMFS, %	P
Gender			0.670		0.784		0.762
Female	7	42.9		42.9		42.9
Male	78	43.2		39.1		41.3
Age(yr)			0.362		0.617		0.447
< 65	60	46.4		40.8		43.9
≥ 65	25	36.0		36.0		36.0
Smoking Index			0.713		0.659		0.767
< 400	18	55.6		44.4		50.0
≥ 400	67	39.6		37.8		39.0
Type of surgery			0.283		0.375		0.498
Lobectomy	57	47.6		42.4		45.5
Pneumonectomy	28	34.1		33.2		33.9
Pathologic T stage			0.341		0.289		0.237
pT1–2	56	46.4		44.1		47.1
pT3	29	37.0		30.3		31.8
Type of N2			0.625		0.596		0.882
a1	31	50.6		44.4		44.8
a2	26	41.3		37.8		41.2
b	28	35.2		34.3		38.1
N of positive nodes			0.115		0.161		0.431
1–3	45	49.2		45.2		46.1
≥ 4	40	36.7		34.1		36.1
PLNR			0.152		0.154		0.265
< 20%	51	48.7		43.8		46.9
≥ 20%	34	34.4		33.0		33.1
N2 stations			0.367		0.363		0.654
Single	31	50.6		44.4		44.8
Multiple	54	38.9		36.9		39.7
POCT			0.316		0.371		0.525
No	13	30.8		30.8		30.8
Yes	72	45.3		40.9		43.5
PORT			0.026*		0.008**		0.018*
No	66	37.7		32.5		35.3
Yes	19	63.2		63.2		63.2

Multivariate analyses of the factors affecting overall survival (OS), loco-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) of lung squamous cell carcinoma (LADC) patients (N = 194)

Characteristics	OS		LRFS		DMFS
Characteristics	HR (95% CI)	P	HR(95% CI)	P	HR (95% CI)	P
Smoking Index		0.000*		0.000*		0.005*
< 400	1		1		1
≥ 400	2.172(1.471–3.207)		2.098(1.421–3.099)		1.739(1.181–2.560)
Pathologic T stage		0.074		0.156		0.002*
pT1–2	1		1		1
pT3	1.560(0.958–2.542)		1.428(0.873–2.337)		2.120(1.308–3.435)
N of positive nodes		0.255		0.234		0.134
1–3	1		1		1
≥ 4	1.403(0.783–2.512)		1.441(0.789–2.632)		1.624(0.861–3.062)
PLNR		0.392		0.435		0.471
< 20%	1		1		1
≥ 20%	1.313(0.704–2.447)		1.291(0.680–2.452)		1.283(0.651–2.528)
N of N2 stations		0.015*		0.046*		0.141
Single	1		1		1
Multiple	2.065(1.148–3.714)		1.818(1.010–3.272)		1.565(0.863–2.839)
POCT		0.004*		0.031*		0.047*
No	1		1		1
Yes	0.417(0.230–0.757)		0.524(0.291–0.942)		0.554(0.310–0.992)
PORT		0.759		0.737		0.444
No	1		1		1
Yes	1.074(0.680–1.697)		0.924(0.584–1.463)		1.196(0.756–1.891)

Patient characteristics

Characteristic	LADC ( N = 194 )				LSCC ( N = 85 )
Characteristic	Total, n (%)	Non-PORT, n (%)	PORT, n (%)	P	Total, n (%)	Non-PORT, n (%)	PORT, n (%)	P
Gender				0.262				0.593
Female	96(49.5)	72(47.4)	24(57.1)		7(8.2)	6(9.1)	1(5.3)
Male	98(50.5)	80(52.6)	18(42.9)		78(91.8)	60(90.9)	18(94.7)
Age (yr)				0.058				0.814
< 65	139(71.6)	104(68.4)	35(83.3)		60(70.6)	47(71.2)	13(68.4)
≥ 65	55(28.4)	48(31.6)	7(16.7)		25(29.4)	19(28.8)	6(31.6)
Smoking Index				0.199				0.058
< 400	127(65.5)	96(63.2)	31(73.8)		18(21.2)	11(16.7)	7(36.8)
≥ 400	67(34.5)	56(36.8)	11(26.2)		67(78.8)	55(83.3)	12(63.2)
Type of surgery				0.028				0.211
Lobectomy	178(91.8)	136(89.5)	42(100)		57(84.0)	42(63.6)	15(78.9)
Pneumonectomy	16(8.2)	16(10.5)	0(0.0)		28(16.0)	24(36.4)	4(21.1)
Pathological T stage				0.044				0.167
T1–2	166(85.6)	126(82.9)	40(95.2)		56(65.9)	46(69.7)	10(52.6)
T3	28(14.4)	26(17.1)	2(4.8)		29(34.1)	20(30.3)	9(47.4)
Type of pN2				0.228				0.989
a1	46(23.7)	38(25.0)	8(19.0)		31(36.5)	24(36.4)	7(36.8)
a2	62(32.0)	44(28.9)	18(42.9)		26(30.6)	20(30.3)	64(31.6)
b	86(44.3)	70(46.1)	16(38.1)		28(32.9)	22(33.3)	6(31.6)
N of positive nodes				0.090				0.581
1–3	87(44.8)	73(48.0)	14(33.3)		45(52.9)	36 (54.5)	9(47.4)
≥ 4	107(55.2)	79(52.0)	28(66.7)		40(47.1)	30(45.5)	10(52.6)
PLNR				0.060				0.832
< 20%	80(41.2)	68(44.7)	12(28.6)		51(60.0)	40(60.6)	11(57.9)
≥ 20%	114(58.8)	84(55.3)	30(71.4)		34(40.0)	26(39.4)	8(42.1)
N of N2 stations				0.422				0.970
Single	46(23.7)	38(25.0)	8(19.0)		31(36.5)	24(36.4)	7(36.8)
Multiple	148(76.3)	114(75.0)	34(81.0)		54(63.5)	42(63.6)	12(63.2)
POCT				0.026				0.512
No	24(12.4)	23(15.1)	1(2.4)		13(15.3)	11(16.7)	2(10.5)
Yes	170(87.6)	129(84.9)	41(97.6)		72(84.7)	55(83.3)	17(89.5)

Postoperative radiotherapy for patients with completely resected pathological stage IIIA-N2 non-small cell lung cancer: a preferential benefit for squamous cell carcinoma

Figures & Tables

Figure 1

Figure 2

Univariate analyses of the factors affecting overall survival (OS), loco-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) of lung squamous cell carcinoma (LADC) patients (N = 194)

Multivariate analyses of the factors affecting overall survival (OS), loco-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) of lung adenocarcinoma (LSCC) patients (N = 85)

Univariate analyses of the factors affecting overall survival (OS), loco-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) of lung adenocarcinoma (LSCC) patients (N = 85)

Multivariate analyses of the factors affecting overall survival (OS), loco-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) of lung squamous cell carcinoma (LADC) patients (N = 194)

Patient characteristics

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