Introduction: We aimed to assess our 25-year experience in order to evaluate the role of adjuvant chemotherapy in patients who undergo pneumonectomy for pN1 NSCLC. Materials and Methods: We retrospectively reviewed the outcomes and medical records of patients undergoing pneumonectomy for NSCLC with pathological diagnosis of pN1, excluding all patients who underwent neoadjuvant treatment. We compared patients treated with adjuvant chemotherapy with patients who did not undergo neoadjuvant treatment during a follow-up soon after surgery. Gray’s test was used to assess differences in the cumulative incidence of relapse or CSS between the different groups. Kaplan–Meier methods were used for drawing overall survival (OS) plots. In order to assess differences in survival between the groups, the log-rank test was used. The cumulative incidence of relapse, CSS, and OS were calculated at 1, 2, 3, 4, and 5 years of follow-up. Results: The 30-day and 90-day mortality rates of our cohort were 6% and 11,6%. Excluding the first three months after surgery (deaths linked to postoperative comorbidity), after 5 years we found no significant differences between the two cohorts (adjuvant CT and no adjuvant CT) in terms of the overall survival (OS) (p: 0.31), cancer-specific survival (CSS) (p: 0.59), disease-free survival (DFS) (p: 0.94), and relapse rate (p: 0.76). Conclusions: Patients with pN1 NSCLC that was completely resected through pneumonectomy and radical lymphadenectomy may represent a particular cohort, which could be strictly followed up without adjuvant chemotherapy.
引言：本研究旨在通过回顾25年经验，评估辅助化疗对接受全肺切除术的pN1非小细胞肺癌（NSCLC）患者的作用。材料与方法：我们回顾性分析了因pN1期NSCLC接受全肺切除术且未接受新辅助治疗患者的临床资料与预后。比较术后早期接受辅助化疗与未接受辅助化疗患者的随访结果。采用Gray检验评估不同组别间累积复发率与癌症特异性生存率（CSS）的差异，通过Kaplan-Meier法绘制总生存期（OS）曲线，组间生存差异采用时序检验进行验证。分别计算随访1、2、3、4、5年的累积复发率、CSS及OS。结果：本队列30天与90天死亡率分别为6%和11.6%。排除术后三个月内与并发症相关的死亡病例后，五年随访数据显示辅助化疗组与未辅助化疗组在总生存期（p=0.31）、癌症特异性生存期（p=0.59）、无病生存期（p=0.94）及复发率（p=0.76）方面均无显著差异。结论：通过全肺切除联合系统性淋巴结清扫实现完全切除的pN1期NSCLC患者可能构成特殊亚群，在未行辅助化疗的情况下进行严密随访或可作为临床管理策略。
肿瘤(癌症)患者之家