Abstract
Introduction
The current study evaluated a large cohort of T2N0M0 NSCLC patients with different T2 descriptors to investigate the prognostic disparities and further externally validate the T category of these patients.
Methods
The Kaplan–Meier Method with the log–rank test was used to plot survival curves. The propensity score matching (PSM) method was used to reduce bias. Univariable and multivariable Cox analyses were used to determine prognostic factors.
Results
A total of 13,015 eligible T2N0M0 NSCLC patients were included. There were 5,287, 2,577 and 5,151 patients in the T2a, T2b and non-sized determined T2N0M0 (T2non-sized) groups, respectively. Before PSM, the survival of T2non-sized patients was comparable to that of T2a patients (P = 0.080) but was superior to that of T2b patients (P < 0.001). After PSM, the survival of T2non-sized patients was inferior to that of T2a patients (P = 0.028) but was similar to that of T2b patients (P = 0.325). The T category was further subdivided based on the specific non-sized T2 descriptors and tumor size. The results of the multivariate Cox analysis found that the prognosis of T2 tumors with visceral pleural invasion (size: 0–30 mm) was better than that of T2a tumors, and the prognosis of T2 tumors with visceral pleural invasion (size: 30–40 mm) was inferior to that of T2a tumors but comparable to that of T2b tumors.
Conclusion
T2 tumors with visceral pleural invasion (size: 30–40 mm) should be assigned to the T2b category, and those with a size interval of 0–30 mm should be assigned to a better prognostic T2a category.
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Data Availability
The data are available in the Surveillance, Epidemiology, and End Results (SEER) database, at https://seer.cancer.gov/.
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Acknowledgements
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Funding
This study is funded by the Clinical Medicine Plus X-Young Scholars Project, Peking University, the Fundamental Research Funds for the Central Universities (Funding receiver: Xun Wang).
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(I) Conception and design: Xun Wang (II) Administrative support: Xun Wang (III) Provision of study materials or patients: Jing-Sheng Cai (IV) Collection and assembly of data: Jing-Sheng Cai (V) Data analysis and interpretation: Jing-Sheng Cai (VI) Manuscript writing: All authors (VII) Final approval of manuscript: All authors.
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Ethical Statement
The Ethics Committee of Peking University People’s Hospital approved this study. This study was conducted in accordance with the Declaration of Helsinki. Authorization was obtained to retrieve SEER data files using the reference code: 12962-Nov2019. This study utilized the de-identified data deposited in the SEER database, and hence the requirement for individual informed consent forms was waived.
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Cai, JS., Wang, X. Investigation of Early-Stage Non-Small Cell Lung Cancer Patients with Different T2 Descriptors: Real Word Data From a Large Database. Lung 201, 415–423 (2023). https://doi.org/10.1007/s00408-023-00635-5
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DOI: https://doi.org/10.1007/s00408-023-00635-5