Neoadjuvant Treatment Is Associated With Superior Outcomes in T4 Lung Cancers With Local Extension

BackgroundNeoadjuvant chemoradiation is associated with improved survival of superior sulcus cancers, but little data exists regarding clinical T4 lung cancers mediastinal invasion. We hypothesized that neoadjuvant treatment would be in cancer patients invasion.MethodsClinical T4-N0/1-M0 non-small cell from 2006-2015 were identified the National Cancer Database. Patients extension to structures undergoing lobectomy, bilobectomy, or pneumonectomy included. Neoadjuvant was defined as preoperative chemotherapy and/or radiation. receiving surgery >120 days after radiation excluded. Study endpoints pathologic margin status and overall survival. To adjust for heterogeneity, a 1:1 propensity match analysis performed.ResultsA total 1101 cT4N0/1M0 analyzed; 595 (54.0%) received primary 506 (46.0%) treatment. therapy fewer positive surgical margins (46 [9.3%] vs 186 [33.1%], P < .001). Multivariate showed an association lower rate (odds ratio 0.220, Overall longer among (65.9 27.5 months, Propensity matching 331 matched pairs patients. Among these, less likely (10.5% 31.3%, those (57.0 .001).ConclusionsIn NCDB, T4N0/1 invasion who receive have decreased rates The use should considered these Clinical performed. A In