Benefits and Relevant Risk Factor Assessment of Neoadjuvant Chemotherapy in Combination with Surgery in Limited-Stage Small-Cell Lung Cancer

医学 化疗 肿瘤科 阶段(地层学) 内科学 单变量分析 新辅助治疗 淋巴结 比例危险模型 子群分析 多元分析 肺癌 外科 淋巴 癌症 置信区间 病理 乳腺癌 生物 古生物学
作者
Huiwen Miao,Shaohua Xu,Meihui Gao,Zhoumiao Chen
出处
期刊:Journal of Environmental Pathology Toxicology and Oncology [Begell House]
卷期号:42 (3): 31-42
标识
DOI:10.1615/jenvironpatholtoxicoloncol.2022045415
摘要

To illustrate the benefits of surgery in conjunction with neoadjuvant chemotherapy in patients with limited-stage small cell lung cancer (LS-SCLC), and to evaluate risk factors affecting patient's survival. Forty-six LS-SCLC patients who received surgery in our center from September 2012 to December 2018 were retrospectively analyzed. Twenty-five patients with LS-SCLC diagnosed after surgery who received postoperative adjuvant chemotherapy were classified into control group, and 21 patients with LS-SCLC who received preoperative neoadjuvant chemotherapy were classified into observation group. The observation group were divided into subgroup 1 (negative lymph nodes) and subgroup 2 (positive lymph nodes). Progression-free survival (PFS) and overall survival (OS) of patients were analyzed. Univariate and multivariate Cox regression were utilized to analyze independent risk factors affecting patient's survival. PFS and OS of patients in the control group and observation group had similar outcomes (P > 0.05). Subgroup 1 and subgroup 2 had similar PFS and OS (P > 0.05). PT2, pN2, BM, and two or more positive lymph nodes were significantly associated with poor PFS and OS (P < 0.05). Furthermore, the pT, number of lymph node positive stations and BM were independent risk factors affecting patient's survival (P < 0.05). Surgery combined with neoadjuvant chemotherapy can achieve long-term survival benefit for some patients with LS-SCLC. It is necessary to find a better plan that enables to select patients suitable for surgery after neoadjuvant chemotherapy.
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