Indeterminate margins after surgery for non–small cell lung cancer (NSCLC) have no known relevance. Researchers looked at how adjuvant therapy affected survival in cancer patients with undetermined margins. Between 2004 and 2015, patients with unclear margins after NSCLC surgery were identified in the National Cancer Database and classified by adjuvant treatment received. Overall survival was the primary outcome, which was assessed using multivariable Cox proportional hazards analysis. Researchers found Indeterminate margins in 0.31% of the 232,986 patients who had NSCLC surgery, and they were linked to a lower survival rate than margin-free resection (adjusted hazard ratio, 1.53; 95% CI, 1.40-1.67). In logistic regression, anatomic resection is protected against the discovery of uncertain margins. About 350 patients with rocky margins got no adjuvant therapy, 96 (17%) received adjuvant chemotherapy, 33 (6%) received adjuvant radiation, and 81 (15%) had adjuvant chemoradiation. When compared to no further treatment, no method of adjuvant therapy was associated with better survival. They discovered uncertain margins were in 0.31% of patients undergoing curative-intent surgery for NSCLC. Compared to total resection, this was linked to a worse overall survival rate that was not improved by adjuvant therapy. Patients with unclear margins after NSCLC surgery should carefully assess the risks and benefits of adjuvant therapy.
Reference:www.jtcvs.org/article/S0022-5223(19)32082-3/fulltext
