Cancer Res Treat.  2021 Oct;53(4):1033-1041. 10.4143/crt.2020.1350.

Prognostic Factor and Clinical Outcome in Stage III Non-Small Cell Lung Cancer: A Study Based on Real-World Clinical Data in the Korean Population

• Kim HC
• Ji W
• Lee JC
• Kim HR
• Song SY
• Choi CM
• Korean Association for Lung Cancer
• Korea Central Cancer Registry

• KMID: 2521579
• DOI: http://doi.org/10.4143/crt.2020.1350

Abstract

Purpose
The optimal treatment for patients with stage III non-small cell lung cancer (NSCLC) remains controversial. This study aimed to investigate prognostic factors and clinical outcome in stage III NSCLC using real-world clinical data in the Korean population.
Materials and Methods
Among 8,110 patients with lung cancer selected from 52 hospitals in Korea during 2014-2016, only patients with stage III NSCLC were recruited and analyzed. A standardized protocol was used to collect clinical information and cox proportional hazards models were used to identify risk factors for mortality.
Results
A total of 1,383 patients (46.5% had squamous cell carcinoma and 40.9% had adenocarcinoma) with stage III NSCLC were enrolled, and their median age was 70 years. Regarding clinical stage, 548 patients (39.6%) had stage IIIA, 517 (37.4%) had stage IIIB, and 318 (23.0%) had stage IIIC. Pertaining to the initial treatment method, the surgery group (median survival period: 36 months) showed better survival outcomes than the non-surgical treatment group (median survival period: 18 months, p=0.001) in patients with stage IIIA. Moreover, among patients with stage IIIB and stage IIIC, those who received concurrent chemotherapy and radiation therapy (CCRT, median survival period: 24 months) showed better survival outcomes than those who received chemotherapy (median survival period: 11 months), or radiation therapy (median survival period: 10 months, p<0.001).
Conclusion
While surgery might be feasible as the initial treatment option in patients with stage IIIA NSCLC, CCRT showed a beneficial role in patients with stage IIIB and IIIC NSCLC.

Keyword

Lung neoplasms; Korea; Surgery; Concurrent chemotherapy and radiation therapy

Figure

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  Fig. 1 Overall survival of patients according to clinical stage.

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  Fig. 2 Overall survival of stage IIIA patients according to initial treatment: in total stage IIIA patients (A), in squamous cell carcinoma stage IIIA patients (B), and in adenocarcinoma stage IIIA patients (C).

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  Fig. 3 Overall survival of stage IIIB and IIIC patients according to initial treatment: in total stage IIIB and IIIC patients (A), in squamous cell carcinoma stage IIIB and IIIC patients (B), and in adenocarcinoma stage IIIB and IIIC patients (C). CCRT, concurrent chemoradiation therapy.

Reference

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