RESULTS

Patient characteristics

A total of 115 patients were enrolled in the trial between May 2011 and July 2015, comprising 80 (69.0%) males and 35 (31.0%) females with a median age of 60 years (range 31–70 years). A total of 61 (53%) patients had a performance score (PS) of 0, a total of 47 patients (41%) had a PS of 1, and a total of 7(6%) had a PS of 2. In total, 54 (47%) patients never smoked, and 61 (53%) patients either previously smoked or were current smokers. A total of 37 (32%) patients were stage T1N2, a total of 66 (57%) patients were stage T2N2, and another 12 (11%) patients were stage T3N2. The predominant histological type was adenocarcinoma (65%), with a small representation of squamous carcinoma (30%). A total of 36 (31%) patients had EGFR mutations, and 79 (69%) patients had wild-type EGFR. In total, 74 (64%) patients received chemotherapy for more than 4 cycles. The characteristics of the patients are shown in Table 1.


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Publishers Alliance 012420 Table 1

Analysis of predictors for survival

The prognostic factors of all patients are summarized in Table 2. In univariate analysis, smoking status, EGFR mutation status, number of chemotherapy cycles (>4 vs ≤4), number of total involved nodes (<2 vs ≥2), and planned radiotherapy had predictive value for both OS and PFS.

Publishers Alliance 012420 Table 2

In the multivariate analysis of all patients, as shown in Table 3, the number of chemotherapy cycles (≥4 vs <4), the total number of lymph nodes involved (<2 vs ≥2), and planned radiotherapy had significant effects on OS and PFS.

Publishers Alliance 012420 Table 3

The median PFS of the PORCT groups was significantly longer than that of non-PORCT groups (group A vs C: 20.0 vs 12.0 months, p=0.023; group A vs D: 20.0 vs 14.0, p=0.002; group B vs C: 18.0 vs 12.0, p=0.021; group B vs D: 18.0 vs 14.0, p=0.002). The median PFS of the EGFR mutant groups was not significantly longer than that of EGFR wild-type groups (group A vs B: 20.0 vs 18.0, p=0.314; group C vs D: 12.0 vs 14.0, p=0.813) (Figure 1). The median OS of the PORCT groups was longer than that of the non-PORCT groups (group A vs C: 32.0 vs 20.0 months, p=0.007; group A vs D: 32.0 vs 20.0, p<0.001; Gro group up B vs C: 28.0 vs 20.0, p=0.017; group B vs D: 28.0 vs 20.0, p<0.001); these differences were statistically significant. The median OS of the EGFR mutant groups was not significantly longer than that of the EGFR wild-type groups (group A vs B:32.0 vs 28.0, p=0.166; group C vs D: p=0.927) (Figure 2).

Publishers Alliance 012420 Figure 1

Publishers Alliance 012420 Figure 2

Compared with that of patients who underwent other types of surgery (mainly lobectomy and bilobectomy), the overall survival rate of patients who underwent pneumonectomy was lower, both in the group that received PORCT and in the group that did not receive PORCT.

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