Surgical Compliance and Survival Outcomes for Patients with Stage T1-2 Non-Small-Cell Lung Cancer.

Abstract

IntroductionOur aim was to determine the relationship between surgical compliance and survival outcomes in patients with stage T1-2 non-small-cell lung cancer (NSCLC).MethodsPatients with T1-2 NSCLC who were diagnosed between 2004 and 2015 were identified from the SEER database. Multivariate logistic regression was used to analyse factors associated with surgical compliance. Kaplan–Meier curves and Cox regression were used to analyse the effects of surgical compliance on overall survival (OS) and cancer-specific survival (CSS).ResultsOf the 221,704 eligible T1-2 NSCLC patients, 106,668 patients recommended surgery. Among them, 99,672 (93.4%) patients were surgical compliance group, and 6996 (6.6%) were surgical noncompliance group. Poor surgical compliance was associated with earlier diagnosis time, old age, male, black race, unmarried status, main bronchus site, poor grade/stage, and lower household income. Patients’ compliance was an independent prognostic factor for OS and CSS of T1-2 NSCLC patients. Multivariate Cox regression showed that surgical noncompliance individuals showed lower OS (hazard ratio [HR] 2.494; 95% confidence interval [CI] 2.423–2.566, p < 0.001) and lower CSS (HR 2.877; 95% CI 2.782–2.974, p < 0.001) compared with surgical compliance patients. In addition, results in the non-surgical group were observed to be similar to those of the surgical noncompliance group.ConclusionWe found that patients’ compliance was an independent prognostic factor for survival in T1-2 NSCLC patients. Poor surgical compliance was associated with earlier diagnosis time, old age, male, black race, unmarried status, main bronchus site, poor grade/stage, and lower household income.