РЕЗУЛЬТАТИ ЛІКУВАННЯ ТА ПРОГНОСТИЧНІ ФАКТОРИ НДКРЛ ІІІ СТАДІЇ: ПОПУЛЯЦІЙНЕ ДОСЛІДЖЕННЯ В ТУНІСІ

• Datum: 2023
• Hauptverfasser: Hergebue, K., Mejri, N., Berrazega, Y., Rachdi, H., El Benna, H., Labidi, S., Boussen, H.
• Format: Artikel
• Sprache: English
• Veröffentlicht: PH Akademperiodyka 2023
• Schlagworte: НДКРЛ; прогноз; ІІІ стадія; ведення хворих.
• Online Zugang: https://exp-oncology.com.ua/index.php/Exp/article/view/2021-1-7
• Назва журналу: Experimental Oncology

Background: Prognostic factors are crucial to guide patient’s selection through therapeutic decisions and outcome prediction. Aim: To investigate prognostic factors associated with improved survival in stage III non-small cell lung cancer. Patients and Methods: We retrospectively reviewed clinical data of 88 stage III non-small cell lung cancer patients treated between 2010–2017. Multidisciplinary evaluation prior to therapy onset was mandatory. Univariate analyses and multivariate logistic regression were performed to identify factors associated with survival. Results: Median follow-up was 28 months, 56% of patients experienced recurrence. Median overall survival (OS) was 19 months. On univariable analysis, improved OS correlated with younger age (p = 0.011), better performance score (ECOG PS < 2) (p < 0.01), absence of weight loss (p = 0.019) and smaller tumor size (≤ 7 cm) (p = 0.005). OS was improved in patients receiving therapy planned by multidisciplinary meeting compared with those who did not (p < 0.01), in those with resected tumors (p = 0.001), responding to therapy (neoadjuvant chemotherapy (p = 0.034) and concurrent chemoradiation (p = 0.001), as well as those with lower neutrophil-lymphocyte ratio (p = 0.026) and lower platelet-lymphocyte ratio (p = 0.003). Postoperative adjuvant therapy increased OS (64 vs 24, p = 0.025). Longer recurrence-free interval, locoregional failure and better perfomance status at recurrence were good prognostic factors for OS. Multivariate analysis showed that only upfront surgery followed by adjuvant therapy (hazard ratio (HR) = 0.61; 95% confidence interval (CI) 0.38–0.96; p = 0.034), adherence to multidisciplinary team decision (HR = 0.26; 95% CI 0.15–0.47; p < 0.01) and tumor size > 7 cm (HR = 2.31; 95% CI 1.29–4.13; p = 0.005) were independent prognostic factors affecting OS. Conclusions: Optimal therapeutic strategy and adherence to the decision provided by the multidisciplinary evaluation of patients played an important role in stage III non-small cell lung cancer outcome.