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

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.