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PLNR≤20% may be a benefit from PORT for patients with IIIA-N2 NSCLC: a large population-based study

Authors Shang X, Li Z, Lin J, Wang H, Wang Z

Received 11 May 2018

Accepted for publication 29 June 2018

Published 17 September 2018 Volume 2018:10 Pages 3561—3567

DOI https://doi.org/10.2147/CMAR.S173856

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo


Xiaoling Shang, Zhenxiang Li, Jiamao Lin, Haiyong Wang, Zhehai Wang

Department of Internal Medicine-Oncology, Shandong Cancer Hospital and Institute, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan 250117, People’s Republic of China

Purpose: Our study was to evaluate the influence of positive lymph nodes ratio (PLNR) on survival for patients with pathological stage IIIA-N2 non-small cell lung cancer (NSCLC) after receiving postoperative radiotherapy (PORT).
Patients and methods: The chi-squared test was used to compare the patient baseline characteristics. Cox proportional hazard model was used to analyze the influence of different variables on overall survival (OS). X-tile model was applied to determine the cutoff values of PLNR. Kaplan–Meier method and log-rank test were used to compare survival differences. Based on different cutoff values of PLNR, Cox proportional hazard model was also used to analyze the influence factors on OS.
Results: Multivariate Cox regression analysis showed that PLNR (P=0.001) and PORT (HR=1.283; 95% CI 1.154–1.426; P<0.001) were significant independent prognostic factors for OS in patients with resected IIIA-N2 NSCLC. The X-tile model was used to screen three different cutoff values including PLNR≤20%, 20%40%. Based on these different cutoff values, we found that patients with PLNR≤20% receiving PORT have a better OS (P=0.007). Further multivariable analysis showed that PORT is an independent prognostic factor of OS only for patients with PLNR≤20% (HR=1.328; 95% CI 1.139–1.549; P<0.001).
Conclusion: PLNR≤20% may be a prognostic factor for patients with IIIA-N2 NSCLC receiving PORT.

Keywords: non-small cell lung cancer, postoperative radiotherapy, positive lymph node ratio, OS, prognosis, X-tile model

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