Explore The Appropriate Surgical Approach For Non-small Cell Lung Cancer Patients With T2aN0M0 And T2bN0M0 Stage In The TNM Staging Of The Eighth Edition Of Lung Cancer

BACKGROUND:The most common treatment for early non-small cell lung cancer is surgery,and the choice of surgical method is closely related to the TNM stage of lung cancer.Lung cancer patients with T2aN0M0 stage(tumor size of 3-5 cm,no lymph node infiltration,no distant metastasis,stage IB)in the eighth edition of the lung cancer TNM staging were divided into T2aN0M0 stage(tumor size 3-4 cm,no lymph node infiltration,no distant metastasis,stage IB)and T2bN0M0 stage(tumor size 4-5 cm,no lymph node infiltration,no distant metastasis,stage? A)in the seventh edition of the TNM staging of lung cancer.For this part of non-small cell lung cancer patients,the TNM stage has changed,and the most appropriate surgical method may also change.OBJECTIVES:Explore the most appropriate surgical method for non-small cell lung cancer patients with T2aN0M0 and T2bN0M0 in the TNM staging of the eighth edition of lung cancer.METHODS:This study retrieved the relevant data of the research subjects from the SEER database,and divided the research subjects into two groups of 3-4 cm and 4-5 cm according to the size of the tumor,and analyzed the relevant data of these two groups of patients.Cox proportional hazard regression model analysis of single factor was performed to screen out the relevant factors that might affect the prognosis of patients;Cox proportional hazard regression model analysis of multiple factors was performed to select factors that could independently affect the prognosis,and to verify whether the stage,surgical method and other factors of lung cancer were independent factors affecting prognosis.According to the different surgical methods,KM survival curve analysis of non-small cell lung cancer patients in T2aN0M0 stage and T2bNOM0 stage of TNM staging of the eighth edition of lung cancer was performed using OS and LCSS as prognostic indicators to compare the prognosis of patients with non-smal]cell lung cancer with different surgical methods.Based on the exploration and analysis using SEER database,the patient clinical information database collected in clinical practice was used for verification.Using the same selection criteria and data analysis methods as the SEER database,the appropriate surgical methods for non-small cell lung cancer patients with tumor sizes of 3-5 cm,no lymph node infiltration,and no distant metastasis were verified.RESULTS:Data from 6,996 patients who met the inclusion criteria were collected from the SEER database.These cases were divided into T2aN0M0(3-4cm)and T2bNOM0(4-5cm)groups according to tumor size.Kaplan-Meier survival curves were used to analyze OS(p=0.018)and LCSS(p=0.001)between the two groups.Univariate and multivariate Cox regression analysis showed that factors such as age,gender.ethnicity,tumor histology type,tumor size,tumor differentiation degree,number of lymph nodes examined,regional lymph node surgery range,and surgical methods were all independent prognostic factors affecting the OS and LCSS of NSCLC patients.The study subjects were grouped according to the surgical method.The Kaplan-Meier survival curve and log-rank test were used to analyze the differences in OS and LCSS between different surgical groups.Both the OS(p<0.001)and LCSS(p<0.001)were analyzed and had significant differences.The lobectomy patients had longer OS and LCSS,and there were no significant differences in OS and LCSS between wedge resection,segmentectomy,and total pneumonectomy.For patients in stage T2aN0M0,the OS and LCSS of lobectomy were the best and statistically significant.There was no significant difference in OS and LCSS between wedge resection,segmentectomy,and pneumonectomy.Others surgical group patients had the worst prognosis.For patients with stage T2bN0M0,the prognosis of patients undergoing lobectomy was significantly better than that of wedge resection.There was no significant difference in the survival rate among patients with total pneumonectomy,segmentectomy,and lobectomy.The prognosis of lobectomy was better than wedge resection.The above results were verified through a clinical database using similar data processing and analysis methods.The results showed that there was no significant statistical difference in the OS of patients between different surgical groups(p=0.224).For patients with T2aN0M0 stage,there was no significant statistical difference in OS of patients with different surgical methods(p=0.708);for patients with T2bN0M0 stage,OS of patients with different surgical methods had significant differences(p<0.001).CONCLUSION:For non-small cell lung cancer patients with T2aN0M0 stage in the TNM staging of the eighth edition of lung cancer,lobectomy is the most suitable surgical method,but wedge,pneumonectomy,and total pneumonectomy should be selected according to the actual situation;In patients with T2bN0M0 stage,lobectomy is better than wedge resection,but the choice between total pneumonectomy,segmentectomy,and lobectomy should be based on the actual situation.