Author/Editor     Bitenc, Marko; Čufer, Tanja; Kern, Izidor; Miklavčič, Martina; Petrovic, Sabrina; Groznik, Vida; Sadikov, Aleksander
Title     Real-life long-term outcomes of upfront surgery in patients with resectable stage I-IIIA non-small cell lung cancer
Type     članek
Vol. and No.     Letnik 56, št. 3
Publication year     2022
Volume     str. 346-354
ISSN     1318-2099 - Radiology and oncology
Language     eng
Abstract     Treatment of early-stage non-small cell lung cancer (NSCLC) is rapidly evolving. When introducing novelties, real-life data on effectiveness of currently used treatment strategies are needed. The present study evaluated outcomes of stage I‐IIIA NSCLC patients treated with upfront radical surgery in everyday clinical practice, between 2010‐2017. Data of 539 consecutive patients were retrieved from a prospective hospital-based registry. All diagnostic, treatment and follow-up procedures were performed at the same thoracic oncology centre according to the valid guidelines. The primary outcome was overall survival (OS) analysed by clinical(c) and pathological(p) TNM (tumour, node, metastases) stage. The impact of clinicopathological characteristics on OS was evaluated using univariable (UVA) and multivariable regression analysis (MVA). With a median follow-up of 53.9 months, median OS and 5-year OS rate in the overall population were 90.4 months and 64.4%. Five-year OS rates by pTNM stage I, II and IIIA were 70.2%, 60.21%, and 49.9%, respectively. Both cTNM and pTNM stages were associated with OS; but only pTNM retained its independent prognostic value (p = 0.003) in MVA. Agreement between cTNM and pTNM was 69.0%. Next to pTNM, age (p = 0.001) and gender (p = 0.004) retained their independent prognostic value for OS. The study showed favourable outcomes of resectable stage I‐IIIA NSCLC treated with upfront surgery in real-life. Relatively low agreement between cTNM and pTNM stages and independent prognostic value of only pTNM, observed in real-life data, suggest that surgery remains the most accurate provider of the anatomical stage of disease and important upfront therapy.
Keywords     resectable NSCLC
upfront surgery
real-life data
overall survival
prognostic factors
operabilni nedrobnocelični rak pljuč
začetna kirurgija
vsakodnevna klinična praksa
celokupno preživetje
napovedni dejavniki