Trimodality therapy for patients with stage III non-small-cell lung cancer: A comprehensive surveillance, epidemiology, and end results analysis
Purpose: Debate exists regarding the optimal management for patients with stage III non-small-cell lung cancer (NSCLC). Recent inclusion of chemotherapeutic data in the Surveillance, Epidemiology, and End Results (SEER) database has made it possible to identify patients with NSCLC who received chemo...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-01-01
|
| Series: | Cancer Treatment and Research Communications |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468294222000612 |
| _version_ | 1811188864458424320 |
|---|---|
| author | Vincent P. Grzywacz Thomas J. Quinn Muayad F. Almahariq Zaid A. Siddiqui Sang W. Kim Thomas M. Guerrero Craig W. Stevens Inga S. Grills |
| author_facet | Vincent P. Grzywacz Thomas J. Quinn Muayad F. Almahariq Zaid A. Siddiqui Sang W. Kim Thomas M. Guerrero Craig W. Stevens Inga S. Grills |
| author_sort | Vincent P. Grzywacz |
| collection | DOAJ |
| description | Purpose: Debate exists regarding the optimal management for patients with stage III non-small-cell lung cancer (NSCLC). Recent inclusion of chemotherapeutic data in the Surveillance, Epidemiology, and End Results (SEER) database has made it possible to identify patients with NSCLC who received chemotherapy. We hypothesized that patients with stage III NSCLC experience improved overall survival from trimodality therapy (TMT) versus definitive chemoradiation therapy (CRT) alone. Materials and Methods: We analyzed the overall survival of stage III NSCLC patients based on the receipt of TMT versus CRT alone. This included crude and adjusted univariate models as well as crude and doubly robust adjusted multivariable analyses, both utilizing propensity score matching and inverse probability of treatment weighting. Factors included in the multivariable analyses included: age, sex, marital status, income, date of diagnosis, primary site, histology, grade, T stage, N stage, and intended treatment. Planned subset analyses were performed for stage III(N2) patients. Results: Adult patients with stage III NSCLC (N = 9008) from the SEER database were included in our analyses. In our univariate analyses, an overall survival benefit was observed for TMT versus CRT (CrudeHR = 0.58, 95% CI = 0.55–0.61, p < 0.001; AdjHR = 0.58, 95% CI = 0.54–0.61, p < 0.001). This persisted in both crude and doubly robust multivariable analyses (CrudeHR = 0.57, 95% CI = 0.53–0.61, p < 0.001; AdjHR = 0.56, 95% CI = 0.53–0.59, p < 0.001). Patients with stage III(N2) disease also demonstrated a significant benefit to OS with TMT versus CRT alone. Conclusion: The significant difference in overall survival seen with TMT suggests this may be an effective treatment approach for select patients. |
| first_indexed | 2024-04-11T14:26:19Z |
| format | Article |
| id | doaj.art-337a375d711e4ed5ae241a3c1174cb83 |
| institution | Directory Open Access Journal |
| issn | 2468-2942 |
| language | English |
| last_indexed | 2024-04-11T14:26:19Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Cancer Treatment and Research Communications |
| spelling | doaj.art-337a375d711e4ed5ae241a3c1174cb832022-12-22T04:18:51ZengElsevierCancer Treatment and Research Communications2468-29422022-01-0132100571Trimodality therapy for patients with stage III non-small-cell lung cancer: A comprehensive surveillance, epidemiology, and end results analysisVincent P. Grzywacz0Thomas J. Quinn1Muayad F. Almahariq2Zaid A. Siddiqui3Sang W. Kim4Thomas M. Guerrero5Craig W. Stevens6Inga S. Grills7Department of Radiation Oncology, Beaumont Health, Royal Oak, MI United States; Corresponding author at: 3601 W. 13 Mile Road Royal Oak, MI 48073.Department of Radiation Oncology, Beaumont Health, Royal Oak, MI United StatesDepartment of Radiation Oncology, Beaumont Health, Royal Oak, MI United StatesDepartment of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA United StatesDepartment of Thoracic Surgery, Beaumont Health, Royal Oak, MI United StatesDepartment of Radiation Oncology, Beaumont Health, Royal Oak, MI United StatesDepartment of Radiation Oncology, Beaumont Health, Royal Oak, MI United StatesDepartment of Radiation Oncology, Beaumont Health, Royal Oak, MI United StatesPurpose: Debate exists regarding the optimal management for patients with stage III non-small-cell lung cancer (NSCLC). Recent inclusion of chemotherapeutic data in the Surveillance, Epidemiology, and End Results (SEER) database has made it possible to identify patients with NSCLC who received chemotherapy. We hypothesized that patients with stage III NSCLC experience improved overall survival from trimodality therapy (TMT) versus definitive chemoradiation therapy (CRT) alone. Materials and Methods: We analyzed the overall survival of stage III NSCLC patients based on the receipt of TMT versus CRT alone. This included crude and adjusted univariate models as well as crude and doubly robust adjusted multivariable analyses, both utilizing propensity score matching and inverse probability of treatment weighting. Factors included in the multivariable analyses included: age, sex, marital status, income, date of diagnosis, primary site, histology, grade, T stage, N stage, and intended treatment. Planned subset analyses were performed for stage III(N2) patients. Results: Adult patients with stage III NSCLC (N = 9008) from the SEER database were included in our analyses. In our univariate analyses, an overall survival benefit was observed for TMT versus CRT (CrudeHR = 0.58, 95% CI = 0.55–0.61, p < 0.001; AdjHR = 0.58, 95% CI = 0.54–0.61, p < 0.001). This persisted in both crude and doubly robust multivariable analyses (CrudeHR = 0.57, 95% CI = 0.53–0.61, p < 0.001; AdjHR = 0.56, 95% CI = 0.53–0.59, p < 0.001). Patients with stage III(N2) disease also demonstrated a significant benefit to OS with TMT versus CRT alone. Conclusion: The significant difference in overall survival seen with TMT suggests this may be an effective treatment approach for select patients.http://www.sciencedirect.com/science/article/pii/S2468294222000612DatabaseSurvivalLocally advanced NSCLCChemoradiationSurgery |
| spellingShingle | Vincent P. Grzywacz Thomas J. Quinn Muayad F. Almahariq Zaid A. Siddiqui Sang W. Kim Thomas M. Guerrero Craig W. Stevens Inga S. Grills Trimodality therapy for patients with stage III non-small-cell lung cancer: A comprehensive surveillance, epidemiology, and end results analysis Cancer Treatment and Research Communications Database Survival Locally advanced NSCLC Chemoradiation Surgery |
| title | Trimodality therapy for patients with stage III non-small-cell lung cancer: A comprehensive surveillance, epidemiology, and end results analysis |
| title_full | Trimodality therapy for patients with stage III non-small-cell lung cancer: A comprehensive surveillance, epidemiology, and end results analysis |
| title_fullStr | Trimodality therapy for patients with stage III non-small-cell lung cancer: A comprehensive surveillance, epidemiology, and end results analysis |
| title_full_unstemmed | Trimodality therapy for patients with stage III non-small-cell lung cancer: A comprehensive surveillance, epidemiology, and end results analysis |
| title_short | Trimodality therapy for patients with stage III non-small-cell lung cancer: A comprehensive surveillance, epidemiology, and end results analysis |
| title_sort | trimodality therapy for patients with stage iii non small cell lung cancer a comprehensive surveillance epidemiology and end results analysis |
| topic | Database Survival Locally advanced NSCLC Chemoradiation Surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2468294222000612 |
| work_keys_str_mv | AT vincentpgrzywacz trimodalitytherapyforpatientswithstageiiinonsmallcelllungcanceracomprehensivesurveillanceepidemiologyandendresultsanalysis AT thomasjquinn trimodalitytherapyforpatientswithstageiiinonsmallcelllungcanceracomprehensivesurveillanceepidemiologyandendresultsanalysis AT muayadfalmahariq trimodalitytherapyforpatientswithstageiiinonsmallcelllungcanceracomprehensivesurveillanceepidemiologyandendresultsanalysis AT zaidasiddiqui trimodalitytherapyforpatientswithstageiiinonsmallcelllungcanceracomprehensivesurveillanceepidemiologyandendresultsanalysis AT sangwkim trimodalitytherapyforpatientswithstageiiinonsmallcelllungcanceracomprehensivesurveillanceepidemiologyandendresultsanalysis AT thomasmguerrero trimodalitytherapyforpatientswithstageiiinonsmallcelllungcanceracomprehensivesurveillanceepidemiologyandendresultsanalysis AT craigwstevens trimodalitytherapyforpatientswithstageiiinonsmallcelllungcanceracomprehensivesurveillanceepidemiologyandendresultsanalysis AT ingasgrills trimodalitytherapyforpatientswithstageiiinonsmallcelllungcanceracomprehensivesurveillanceepidemiologyandendresultsanalysis |