Real-life long-term outcomes of upfront surgery in patients with resectable stage I-IIIA non-small cell lung cancer

Characteristic	N (%)
No. of patients	539
Age in years: median (range)	64 (39–83)
< 65 years	271 (50.3)
≥ 65 years	268 (49.7)
Gender
Male	315 (58.4)
Female	224 (41.6)
Smoking status (n = 537; completeness = 99.6 %)
Current	257 (47.8)
Former	212 (39.5)
Never	68 (12.7)
Histology
Adenocarcinoma	341 (63.3)
Squamous-cell carcinoma	195 (36.2)
NSCLC other rare types	3 (0.6)
EGFR^a status in non-squamous NSCLC
(n = 334; completeness = 99.7%)
Positive	41 (12.3)
Negative	292 (87.7)
ALK^b status in non-squamous NSCLC
(n = 334; completeness = 39.2%)
Positive	7 (5.3)
Negative	124 (94.7)
Clinical TNM stage^c
I	309 (57.3)
II	145 (26.9)
IIIA	85 (15.8)
Clinical T stage
T1	242 (44.9)
T2	193 (35.8)
T3	96 (17.8)
T4	8 (1.5)
Clinical N stage
N0	393 (72.9)
N1	102 (18.9)
N2	44 (8.2)
Pathological TNM stage^c (n = 532; completeness = 98.7%)
I	296 (55.6)
II	150 (28.2)
III	86 (16.2)
Pathological T stage (n = 537; completeness = 99.6%)
T1	223 (41.5)
T2	248 (46.2)
T3	58 (10.8)
T4	8 (1.5)
Pathological N stage (n = 534; completeness = 99.1%
N0	386 (72.3)
N1	81 (15.2)
N2	67 (12.5)
Surgery type
Lobectomy	459 (85.2)
Bilobectomy	31 (5.8)
Pneumonectomy	49 (9.1)
Adjuvant treatment
Platinum-based chemotherapy	146 (27.1)
Postoperative radiotherapy	36 (6.7)

[i] ^aEGFR: epidermal growth factor receptor; ^bALK: anaplastic lymphoma kinase; ^cstage defined by American Joint Committee on Cancer staging

Table 2

Comparison between clinical (c) and pathological (p) TNM staging

2A. Comparison between clinical and pathological TNM stage (n = 532; completeness = 98.7%)

	c Stage I (N = 303) N (%)	c Stage II (N = 144) N (%)	c Stage IIIA (N = 85) N (%)
p Stage I	246 (81%)	38 (26%)	12 (14%)
p Stage II	40 (13%)	79 (55%)	31 (36%)
p Stage IIIA	17 (6%)	27 (19%)	42 (49%)

[i] Overall agreement: 367 out of 532 cases (69.0%)

2B

Comparison between clinical and pathological T stage (n = 537; completeness = 99.6%)

	cT1 (N = 240) N (%)	cT2 (N = 193) N (%)	cT3 (N = 96) N (%)	cT4 (N = 8) N (%)
pT1	187 (78%)	24 (13%)	10 (10%)	2 (25%)
pT2	46 (19%)	158 (82%)	41 (43%)	3 (37%)
pT3	5 (2%)	9 (4%)	42 (44%)	2 (25%)
pT4	2 (1%)	2 (1%)	3 (3%)	1 (13%)

[i] Overall agreement between: 388 out of 537 cases (72.3%)

2C

Comparison between clinical and pathological N stage (n = 534; completeness = 99.1%)

	cN0 (N = 388) N (%)	cN1 (N = 102) N (%)	cN2 (N = 44) N (%)
pN0	324 (84%)	49 (48%)	13 (30%)
pN1	42 (11%)	34 (33%)	5 (11%)
pN2	22 (6%)	19 (19%)	26 (59%)

[i] Overall agreement: 384 out of 534 cases (71.9%)

Overall survival of patients with completely resected stage I–III A non-small cell lung cancer.

Overall survival by clinical TNM stage **(A)**, pathological TNM stage **(B)**, clinical N stage **(C)** and pathological N stage **(D)**.

Table 3

Univariate analyses of overall survival

Factor	p-value	HR (95% CI)
Age
< 65		1
≥ 65	0.002	1.59 (1.18 – 2.15)
Gender
Male		1
Female	0.001	0.59 (0.43 – 0.81)
Smoking status
never		1
current or former	0.115	1.50 (0.91 – 2.47)
Histology
adenocarcinoma or NOS		1
squamous cell carcinoma	0.111	1.28 (0.95 – 1.73)
EGFR status^a (positive vs negative)
negative		1
positive	0.111	0.56 (0.27 – 1.14)
Clinical TNM stage	0.027*
I		1
II	0.034	1.44 (1.03 – 2.02)
IIIA	0.025	1.57 (1.06 – 2.34)
Clinical T stage	0.001*
T1		1
T2	0.882	0.97 (0.69 – 1.38)
T3 or T4	0.001	1.86 (1.29 – 2.68)
Clinical N stage	0.317*
N0		1
N1	0.958	0.99 (0.67 – 1.46)
N2	0.137	1.44 (0.89 – 2.34)
Pathological TNM stage	0.003*
I		1
II	0.030	1.46 (1.04 – 2.06)
IIIA	0.001	1.90 (1.29 – 2.79)
Pathological T stage	0.007*
T1		1
T2	0.019	1.49 (1.07 – 2.07)
T3 or T4	0.004	1.92 (1.23 – 2.98)
Pathological N stage	0.002*
N0		1
N1	0.054	1.48 (0.99 – 2.20)
N2	0.001	1.93 (1.29 – 2.87)

[i] ^aonly in non-squamous NSCLC; ^*for the whole variable

Table 4

Multivariate analyses of overall survival (separate for clinical and for pathological stage)

Cox regression model with clinical stage	p-value	HR (95% CI)
Age
< 65		1
≥ 65	0.003	1.58 (1.17 – 2.14)
Gender
Male		1
Female	0.006	0.63 (0.46 – 0.88)
Clinical TNM stage	0.092*
I		1
II	0.078	1.36 (0.97 – 1.91)
IIIA	0.068	1.46 (0.97 – 2.18)
Cox regression model with pathological stage	p-value	HR (95% CI)
Age
< 65		1
≥ 65	0.001	1.68 (1.24 – 2.28)
Gender
Male		1
Female	0.004	0.62 (0.45 – 0.86)
Pathological TNM stage	0.003*
I		1
II	0.076	1.37 (0.97 – 1.93)
IIIA	0.001	1.95 (1.32 – 2.88)

[i] ^*for the whole variable

References

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Articles in this issue

DOI: https://doi.org/10.2478/raon-2022-0030 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 346 - 354

Submitted on: May 17, 2022

Accepted on: Jun 10, 2022

Published on: Aug 14, 2022

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

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© 2022 Marko Bitenc, Tanja Cufer, Izidor Kern, Martina Miklavcic, Sabrina Petrovic, Vida Groznik, Aleksander Sadikov, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 56 (2022): Issue 3 (September 2022)

Real-life long-term outcomes of upfront surgery in patients with resectable stage I-IIIA non-small cell lung cancer

Figures & Tables

Table 1

Table 2

2B

2C

Figure 1

Figure 2

Table 3

Table 4

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