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Clinical Guideline-Guided Outcome Consistency for Surgically Resected Stage III Non-Small Cell Lung Cancer: A Retrospective Study

机译:临床指南引导结果一致性用于手术切除阶段III III非小细胞肺癌:回顾性研究

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摘要

Evidence-based guidelines provide valuable management recommendations that can significantly improve patient treatment and outcome, thereby reducing clinical variability. Recent clinical trials demonstrated that personalised treatments based on genomic and immune profiles can contribute to the prognosis of non-small cell lung cancer (NSCLC). This retrospective study investigated whether guideline-consistency, including adjuvant treatments after surgical resection (ATSR) and guideline-matched first-line treatment for recurrence (GMT-R), could influence overall survival (OS). From 2006 to 2017, 308 patients with pathological stage III NSCLC were eligible, among whom 207 (67.2%) recurrence cases were identified. ATSR and GMT-R were allowed in 164 (53.2%) and 129 (62.3%) cases, respectively. The 5-year OS in guideline-consistent cases receiving ATSR and GMT-R was significantly better than that in guideline-inconsistent cases (p < 0.01). Subgroup analyses further revealed that the 5-year OS after propensity adjustment was significantly better in guideline-consistent than in guideline-inconsistent cases (p < 0.01). Hence, guideline-consistent treatment alternatives effectively contribute to better outcomes.
机译:基于证据的指导方针提供了有价值的管理建议,可以显着改善患者的治疗和结果,从而降低临床变异性。最近的临床试验表明,基于基因组和免疫谱的个性化治疗可以有助于非小细胞肺癌的预后(NSCLC)。该回顾性研究调查了指南一致性,包括手术切除后(ATSR)和准则匹配的复发(GMT-R)后的佐剂治疗,可以影响整体存活(OS)。从2006年到2017年,308例病理阶段III NSCLC患者符合条件,其中包括207例(67.2%)复发案件。分别在164(53.2%)和129例(62.3%)案件中允许ATSR和GMT-R。接受ATSR和GMT-R的指南一致案件中的5年OS明显优于指南 - 不一致的情况(P <0.01)。亚组分析进一步揭示了在倾向调整后的5年的操作系统在指导方面明显更好,而不是在指南 - 不一致的情况下(P <0.01)。因此,指南一致的治疗方法有效地促进了更好的结果。

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