BACKGROUND: For non-small cell lung cancer (NSCLC) patients with pN2 status, the use of postoperative radiotherapy (PORT) remains controversial. Here, we investigated the association between different clinicopathological features and postoperative therapy and local control and survival in patients with resected pN2 NSCLC. METHODS: We retrospectively analyzed 83 patients with pN2 NSCLC who underwent resection at Vanderbilt University Medical Center between 1994 and 2004. The relationship between 10 prognostic factors-gender, age at diagnosis, histology, tumor size, number of nodal stations involved, positive node number, surgical margin, extracapsular extension (ECE), and use of postoperative chemotherapy and PORT-and 2-year local recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), recurrence-free survival (RFS), and overall survival (OS) rates was evaluated. Univariate and multivariate analyses were conducted using the Kaplan-Meier method and Cox proportional hazards ratios, respectively. RESULTS: On univariate analysis, PORT was significantly associated with greater LRFS, RFS, and OS rates, whereas chemotherapy was associated with a trend toward a higher OS rate. Negative surgical margins were predictive of a higher OS rate, and negative ECE was associated with higher LRFS and RFS rates. On multivariate analysis, only PORT and negative ECE were associated with a higher LRFS rate. On subgroup analysis, in negative ECE patients, PORT was significantly associated with a higher OS rate. CONCLUSIONS: PORT is associated with a higher OS rate for patients with resected pN2 NSCLC with negative ECE but not with positive ECE. The absence of ECE may serve as a useful prognostic variable in the selection of pN2 NSCLC patients for PORT and warrants further investigation in randomized clinical trials.
BACKGROUND: For non-small cell lung cancer (NSCLC) patients with pN2 status, the use of postoperative radiotherapy (PORT) remains controversial. Here, we investigated the association between different clinicopathological features and postoperative therapy and local control and survival in patients with resected pN2NSCLC. METHODS: We retrospectively analyzed 83 patients with pN2NSCLC who underwent resection at Vanderbilt University Medical Center between 1994 and 2004. The relationship between 10 prognostic factors-gender, age at diagnosis, histology, tumor size, number of nodal stations involved, positive node number, surgical margin, extracapsular extension (ECE), and use of postoperative chemotherapy and PORT-and 2-year local recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), recurrence-free survival (RFS), and overall survival (OS) rates was evaluated. Univariate and multivariate analyses were conducted using the Kaplan-Meier method and Cox proportional hazards ratios, respectively. RESULTS: On univariate analysis, PORT was significantly associated with greater LRFS, RFS, and OS rates, whereas chemotherapy was associated with a trend toward a higher OS rate. Negative surgical margins were predictive of a higher OS rate, and negative ECE was associated with higher LRFS and RFS rates. On multivariate analysis, only PORT and negative ECE were associated with a higher LRFS rate. On subgroup analysis, in negative ECE patients, PORT was significantly associated with a higher OS rate. CONCLUSIONS: PORT is associated with a higher OS rate for patients with resected pN2NSCLC with negative ECE but not with positive ECE. The absence of ECE may serve as a useful prognostic variable in the selection of pN2NSCLCpatients for PORT and warrants further investigation in randomized clinical trials.
Authors: Jean-Yves Douillard; Rafael Rosell; Mario De Lena; Francesco Carpagnano; Rodryg Ramlau; Jose Luis Gonzáles-Larriba; Tomasz Grodzki; Jose Rodrigues Pereira; Alain Le Groumellec; Vito Lorusso; Claude Clary; Antonio J Torres; Jabrail Dahabreh; Pierre-Jean Souquet; Julio Astudillo; Pierre Fournel; Angel Artal-Cortes; Jacek Jassem; Leona Koubkova; Patricia His; Marcello Riggi; Patrick Hurteloup Journal: Lancet Oncol Date: 2006-09 Impact factor: 41.316
Authors: Justin E Bekelman; Kenneth E Rosenzweig; Peter B Bach; Deborah Schrag Journal: Int J Radiat Oncol Biol Phys Date: 2006-07-11 Impact factor: 7.038
Authors: R Rosell; J Gómez-Codina; C Camps; J Maestre; J Padille; A Cantó; J L Mate; S Li; J Roig; A Olazábal Journal: N Engl J Med Date: 1994-01-20 Impact factor: 91.245
Authors: J F Régnard; P Magdeleinat; D Azoulay; P Dartevelle; M Deneuville; A Rojas-Miranda; P Levasseur Journal: Eur J Cardiothorac Surg Date: 1991 Impact factor: 4.191
Authors: John L Mikell; Theresa W Gillespie; William A Hall; Dana C Nickleach; Yuan Liu; Joseph Lipscomb; Suresh S Ramalingam; Raj S Rajpara; Seth D Force; Felix G Fernandez; Taofeek K Owonikoko; Rathi N Pillai; Fadlo R Khuri; Walter J Curran; Kristin A Higgins Journal: J Thorac Oncol Date: 2015-03 Impact factor: 15.609