Patient and hospital factors for outcomes of completely resected, node-negative nonsmall cell lung cancer.

IF 1.9 4区医学 Q3 ONCOLOGY

Japanese journal of clinical oncology Pub Date : 2025-04-07 DOI:10.1093/jjco/hyaf057

Yasushi Goto, Hiroyuki Sakurai, Kiyotaka Yoh, Kazuya Takamochi, Takehito Shukuya, Tomoyuki Hishida, Masahiro Tsuboi, Koichi Yoshida, Yasuhisa Ohde, Sakae Okumura, Masataka Taguri, Hideo Kunitoh

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引用次数: 0

Abstract

Objectives: To evaluate outcomes of early-stage nonsmall cell lung cancer (NSCLC) patients in relation to patient and hospital factors.

Summary background data: Results of randomized controlled trials (RCTs) may not be applicable to daily practice.

Methods: Outcomes of patients who had undergone curative surgery for node-negative NSCLC were retrospectively evaluated. They were either participants in an RCT (JCOG0707) or those excluded from it. "Excluded patients" were either ineligible to ("ineligible cohort") or eligible but did not participate ("eligible cohort") in the RCT. Correlations between hospital volume, study forwardness, and patient outcomes were also analyzed.

Results: A total of 5921 patients, 917 in JCOG0707, were evaluated. The overall survival (OS) of the eligible cohort (n = 2616) was similar to the JCOG0707 cohort with an adjusted hazard ratio (aHR) of 1.01 (P = .90), while that of the ineligible cohort (n = 2388) was significantly worse, with an aHR of 1.67 (P < .0001). Both deaths from lung cancer and from other causes led to the inferior outcome. The OS of patients in the ineligible cohort, excluded from the trial due solely to the presence of concomitant malignancy (n = 704), was significantly worse than OS in the eligible cohort, but disease-specific survivals were not significantly different. Hospital volume did not affect OS (high vs low: aHR 0.91, P = .13), but high-volume hospitals had lower "other-cause" mortality (aHR 0.79, P = .02).

Conclusions: RCT-ineligible patients had worse OS, and their excess mortalities are mainly attributed to nonlung-cancer-specific deaths.

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患者和医院因素对完全切除淋巴结阴性非小细胞肺癌预后的影响

目的：评价早期非小细胞肺癌（NSCLC）患者预后与患者和医院因素的关系。摘要背景资料：随机对照试验（RCTs）的结果可能不适用于日常实践。方法：回顾性分析经手术治疗的淋巴结阴性非小细胞肺癌患者的预后。他们要么是随机对照试验（JCOG0707）的参与者，要么是被排除在外的参与者。“被排除的患者”要么不符合条件（“不符合队列”），要么符合条件但未参加RCT（“符合队列”）。还分析了医院容量、研究前瞻和患者预后之间的相关性。结果：共纳入5921例患者，其中JCOG0707组917例。符合条件的队列（n = 2616）的总生存期（OS）与JCOG0707队列相似，校正风险比（aHR）为1.01 (P = 0.90)，而不符合条件的队列（n = 2388）的总生存期（aHR）明显差，aHR为1.67 (P)。结论：rct不符合条件的患者OS较差，其超额死亡率主要归因于非肺癌特异性死亡。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Japanese journal of clinical oncology 医学-肿瘤学

CiteScore

3.70

自引率

8.30%

发文量

177

审稿时长

3-8 weeks

期刊介绍： Japanese Journal of Clinical Oncology is a multidisciplinary journal for clinical oncologists which strives to publish high quality manuscripts addressing medical oncology, clinical trials, radiology, surgery, basic research, and palliative care. The journal aims to contribute to the world"s scientific community with special attention to the area of clinical oncology and the Asian region. JJCO publishes various articles types including: ・Original Articles ・Case Reports ・Clinical Trial Notes ・Cancer Genetics Reports ・Epidemiology Notes ・Technical Notes ・Short Communications ・Letters to the Editors ・Solicited Reviews