Impact of Traditional Chinese Medicine therapy focused on strengthening the body on postoperative recurrence and metastasis prevention in stage IIIA non-small cell lung cancer: a real-world retrospective cohort study.

Background: This study aimed to evaluate the impact of Traditional Chinese Medicine (TCM) therapy focused on strengthening the body on postoperative recurrence and metastasis prevention in patients with stage IIIA non-small cell lung cancer (NSCLC).

Methods: This retrospective cohort study analyzed real-world data from patients with stage IIIA NSCLC who underwent radical surgery between January 2016 and January 2022 at Longhua Hospital, Shanghai University of Traditional Chinese Medicine. Patients were classified into an exposed group, receiving adjuvant chemotherapy or radiotherapy combined with TCM therapy, and a non-exposed group, receiving only adjuvant chemotherapy or radiotherapy. The primary outcome was disease-free survival (DFS), while secondary endpoints included 1-year, 2-year, and 3-year DFS rates (DFSR).

Results: A total of 700 patients were included, with 340 in the exposed group and 360 in the non-exposed group. After propensity score matching, the exposed group demonstrated a significantly longer median DFS compared to the non-exposed group (32.0 months [95% CI 24.0-38.0] vs. 17.0 months [95% CI 15.0-20.0], p < 0.001) and higher 1-year, 2-year, and 3-year DFS rates (78% vs. 63%, 56% vs. 38%, and 44% vs. 24%, respectively; p < 0.001). TCM therapy was associated with reduced recurrence and metastasis (HR = 0.58, 95% CI 0.48-0.70, p < 0.001). Subgroup analysis showed greater DFS benefits following TCM therapy in patients with N2 involvement and those over 65 years (both p < 0.05).

Conclusions: TCM therapy focused on strengthening the body may prolong DFS and improve DFSR in postoperative stage IIIA NSCLC patients. However, further large-scale prospective studies are needed to validate these findings.