Evaluating the fate of patients who undergo resections of very large, node-negative lung cancers using the National Cancer DataBase.

摘要: OBJECTIVES To determine whether there are differences in survival associated with different treatment modalities among patients lymph node-negative, very large non-small-cell lung cancers (NSCLCs). METHODS The National Cancer DataBase was used to identify diagnosed NSCLCs >7 cm (T3) without node involvement (N0) or metastatic disease (M0) from 1999 2006. Surgical therapy included surgery alone, neoadjuvant chemoradiation chemotherapy, followed by adjuvant chemotherapy and postoperative radiation (PORT). 5-year overall (OS) estimated the Kaplan-Meier method comparisons were made using log-rank tests Cox regression models. RESULTS Of 2296 identified cT3N0M0 disease, 45% underwent surgical therapy. OS rate 38%. Across regimens, a significant difference OS. Neither nor improved use of relative alone [hazard ratio (HR) 0.70; 95% confidence interval (CI) 0.54-0.91, P = 0.008]. PORT detrimental effect on [HR 2.04; CI 1.38-3.03, < 0.001]. CONCLUSIONS Large T3N0 appear be optimally treated resection chemotherapy.