The following is a summary of “Comparative characteristics of stage I non-small cell lung cancer (NSCLC) patients segregated by quality of surgery and survival in a population-based cohort,” published in the April 2023 issue of Oncology by Shao, et al.
Some people make it through despite having a low-quality NSCLC resection. Patient characteristics were analyzed across 4 surgical quality and survival-based cohorts. Researchers looked at stage I resections in a population-based sample that survived more than 120 days after surgery between 2009 and 2018. Applying the strict definition of ‘full resection’ and 3-year survival as ‘excellent’ established by the International Society for the Study of Lung Cancer, they divided patients into 4 pairs: The 4 possible outcomes are as follows: 1) Good surgery/good survival; 2) Good surgery/poor survival; 3) Poor surgery/good survival (reference); 4) Poor surgery/poor survival.
Multivariate multinomial logistic regression was used to estimate the Odds Ratio (OR) of operation quality and survival, while the Chi-square and Kruskal-Wallis tests were performed for description. Of the 1,515 patients, 31%, 7%, 51%, and 12% were placed in Groups 1-4, in that order. Group 2 in the ‘mis-match dyads’ (Group 2 and 3) had a higher prevalence of age (70 vs. 66, P<0.01), Medicaid (P=0.01), ever-smoking (96% vs. 85%, P<0.01), and squamous cell carcinoma than Group 3 (85% vs. 85%, P<0.01). Older patients (1.06 odds), male (1.78 odds), enrolled in Medicaid (2.16 odds), and had a smoking history (3.25 odds) fared worse after surgery, good or bad.
Patients with tumors of 2-3 cm (OR=2.01) and more than 3 cm (OR=1.77) and 1.64% had a worse chance of survival after subpar surgery; patients with commercial insurance had a 36% lower risk of subpar survival. When comparing robotic-assisted surgery to open thoracotomy, patients had a >4-fold higher chance of having good surgery than mediocre surgery but good survival. Comparing biomarker profiles across dyads is possible by distinguishing factors linked with good/poor survival after good/bad quality lung cancer surgery.
Source: abstractsonline.com/pp8/#!/10828/presentation/1559
