Impact of Postoperative Therapy on Survival Outcomes in Non-small Cell Lung Cancer Patients With Microscopic Residual Disease

Background/Aim: The aim of the study was to describe the specific characteristics of patients with microscopic residual disease (R1) after surgical resection for non-small cell lung cancer and to evaluate the effect of postoperative therapy in R1 patients.

Patients and Methods: We retrospectively reviewed the clinical data of 3,296 patients. Enrolled R1 patients were divided into two groups: those who received postoperative therapy (PT) and those who did not receive postoperative therapy (NPT).

Results: A total of 52 R1 patients were enrolled. Of those, 27 (51.9%) underwent extended resections in addition to the standard surgery, 37 patients were assigned to the PT group and 15 to the NPT group. The PT group exhibited significantly longer overall survival (OS) than the NPT group (p<0.01, 5-year OS rate: 62.7% vs. 17.9%). There was no difference in progression-free survival (PFS) between the two groups (p=0.34, 5-year PFS rate: 38.7% vs. 22.2%). Age (<70 years old) and postoperative therapy positively impacted OS (p=0.03, and p=0.01, respectively).

Conclusion: R1 resection after surgical resection for non-small cell lung cancer was more likely to occur in the patients receiving extended surgical resection. The PT group demonstrated a significantly better prognosis than the NPT group.