PLoS ONE (Jan 2024)

Treatment strategies for stage IA non-small cell lung cancer: A SEER-based population study.

  • Bo Wu,
  • Xiang Zhang,
  • Nan Feng,
  • Zhuozheng Hu,
  • Jiajun Wu,
  • Weijun Zhou,
  • Yiping Wei,
  • Wenxiong Zhang,
  • Kang Wang

DOI
https://doi.org/10.1371/journal.pone.0298470
Journal volume & issue
Vol. 19, no. 4
p. e0298470

Abstract

Read online

BackgroundThere are various therapeutic methods for treating stage IA (T1N0M0) non-small cell lung cancer (NSCLC), but no studies have systematically assessed multiple treatments to determine the most effective therapy.MethodsStage IA NSCLC patient data collected between 2004 and 2018 were gathered from the Surveillance, Epidemiology, and End Results (SEER) database. Treatment modalities included observation, chemotherapy alone (CA), radiation alone (RA), radiation+chemotherapy (RC), surgery alone (SA), surgery+chemotherapy (SC), surgery+radiation (SR) and surgery+radiation+chemotherapy (SRC). Comparisons were made of overall survival (OS) and lung cancer-specific survival (LCSS) among patients based on different therapeutic methods by survival analysis.ResultsUltimately, 89147 patients with stage IA NSCLC between 2004 and 2018 were enrolled in this study. The order of multiple treatment modalities based on the hazard ratio (HR) for OS for the entire cohort revealed the following results: SA (HR: 0.20), SC (HR: 0.25), SR (HR: 0.42), SRC (HR: 0.46), RA (HR: 0.56), RC (HR: 0.72), CA (HR: 0.91) (PConclusionSA appeared to be the optimal treatment modality for patients with stage IA NSCLC, and lobectomy was associated with the best prognosis. There may be some indication and selection bias in our study, and the results of this study should be confirmed in a prospective study.