Chinese Journal of Lung Cancer (Oct 2009)
Research on Postoperative Radiotherapy for Non-small Cell Lung Cancer of Stage IIIA (N2) according to the Failure Patterns after Pulmonary Resection
Abstract
Background and objective Postoperative radiotherapy (PORT) after complete resection of non-small cell lung cancer (NSCLC) has been introduced in order to reduce locoregional recurrence, but it remains controversy whether PORT can improve survival. Therefore, we want to investigate the effect of PORT and the relationship between failure patterns and primarily location of stage IIIA (N2) in NSCLC. Methods This retrospective analysis included 233 patients who underwent resection of NSCLC, first recurrence involving a local-regional site. It illustrated the factors affecting local recurrence and the sites of failure on the basis of lobe of primary tumor. Results Multivariable analysis demonstrated the number of positive lymph nodes (P=0.003), T stage (P<0.001), histological type (P=0.038), modus operandi (P=0.013) and the number of mediastinal lymph node stations involved (P=0.018) were the independent factors. For all patients, the most common site of failure was the bronchial stump/staple line, which was present more often in those who had a wedge resection than in those who had a more radical procedure (P<0.001). The local-region frequency of squamous was higher than adenocarcinoma carcinoma (P=0.025). The recurrence frequency of mediastinal lymph node among T1 and T2-3 were 36.4%, 62.0% (P=0.009) respectively. The localregion recurrence among primarily tumor location were different. Conclusion The number of positive lymph nodes, T stage, histological type, modus operations and the number of mediastinal lymph node stations involved were the independent factors in IIIA (N2) NSCLC.
