Canadian Respiratory Journal

Research Article

Operative versus Nonoperative Treatment in Patients with Advanced Non-Small-Cell Lung Cancer: Recommended for Surgery

Table 3

The multivariable Cox proportional hazard regression analyses for stage IIIA.


Variables	Unadjusted model		Adjusted model
Variables	HR (95% CI)	value	HR (95% CI)	value

Nonoperation	Reference		Reference
Operation	0.44 (0.31∼0.64)	<0.001	0.2 (0.04∼1)	0.051
Age	1.01 (0.99∼1.02)	0.611	1.04 (1∼1.07)	0.058
Sex
Male	Reference		Reference
Female	0.54 (0.38∼0.76)	<0.001	0.37 (0.17∼0.82)	0.014
Race
Caucasian	Reference		Reference
African American	0.56 (0.24∼1.27)	0.163	0.11 (0.03∼0.39)	0.001
American Indian/Alaska native	NA (NA∼NA)	NA	NA (NA∼NA)	NA
Asian or Pacific Islander	0.82 (0.51∼1.32)	0.408	0.35 (0.14∼0.88)	0.025
Marital status at diagnosis, n (%)
Single	Reference		Reference
Unmarried or domestic partner	1.6 (0.37∼6.87)	0.524	0 (0∼Inf)	0.998
Married	1.08 (0.66∼1.77)	0.773	0.69 (0.28∼1.73)	0.427
Separated	3.15 (0.42∼23.58)	0.265	NA (NA∼NA)	NA
Divorced	1.34 (0.75∼2.39)	0.328	0.45 (0.13∼1.54)	0.203
Widowed	1.06 (0.62∼1.82)	0.826	0.78 (0.26∼2.31)	0.647
Primary site
Main bronchus	Reference		Reference
Upper lobe and lung	0.26 (0.11∼0.66)	0.004	1.4 (0.13∼15.42)	0.784
Middle lobe and lung	0.25 (0.08∼0.76)	0.015	0.72 (0.05∼10.37)	0.807
Lower lobe and lung	0.3 (0.12∼0.77)	0.012	1.29 (0.11∼15.76)	0.841
Overlapping lesion of lung	0 (0∼Inf)	0.995	NA (NA∼NA)	NA
Grade
I: well differentiated	Reference		Reference
II: moderately differentiated	3.43 (1.46∼8.09)	0.005	6.2 (2.09∼18.4)	0.001
III: poorly differentiated	4.06 (1.75∼9.4)	0.001	4.68 (1.51∼14.5)	0.008
IV: undifferentiated anaplastic	1.29 (0.27∼6.2)	0.755	0.43 (0.06∼2.96)	0.392
Laterality
Right	Reference		Reference
Left	0.99 (0.7∼1.4)	0.957	0.72 (0.37∼1.39)	0.322
Bilateral involvement	1.74 (0.43∼7.11)	0.441	1.05 (0.17∼6.64)	0.959
Histology
Epithelial neoplasms	Reference		Reference
Squamous cell neoplasms	0.66 (0.42∼1.03)	0.069	0.21 (0.07∼0.66)	0.008
Adenomas and adenocarcinomas	0.28 (0.18∼0.46)	<0.001	0.12 (0.04∼0.36)	<0.001
Acinar cell neoplasms	0 (0∼Inf)	0.994	0 (0∼Inf)	0.997
Others†	0.23 (0.05∼0.96)	0.044	0.49 (0.07∼3.59)	0.482
Radiation	0.91 (0.65∼1.29)	0.609	1.82 (0.72∼4.59)	0.205
Chemotherapy	0.84 (0.58∼1.2)	0.337	0.44 (0.19∼1.05)	0.064
Type of surgery
Nonoperation	Reference		Reference
Local tumor destruction	1.38 (0.64∼2.98)	0.418	15.3 (1.29∼181.18)	0.031
Resection of less than one lobe	0.4 (0.26∼0.6)	<0.001	2.13 (0.47∼9.64)	0.324
Lobectomy	0.33 (0.12∼0.89)	0.028	NA (NA ∼ NA)	NA
Lobe or bilobectomy extended	NA (NA ∼ NA)	NA	NA (NA ∼ NA)	NA
Pneumonectomy	NA (NA ∼ NA)	NA	NA (NA ∼ NA)	NA
Extended pneumonectomy	NA (NA ∼ NA)	NA	NA (NA ∼ NA)	NA

†, histology and other types included: transitional cell papillomas and carcinomas (n = 1), mucoepidermoid neoplasms (n = 5), cystic, mucinous, and serous neoplasms (n = 72), and complex epithelial neoplasms (n = 74). local tumor destruction included laser ablation or cryosurgery and electrocautery; fulguration (included the use of hot forceps for tumor destruction). Excision or resection of less than one lobe included excision, laser excision, bronchial sleeve resection only, wedge resection, and segmental resection (including lingulectomy). The model adjusted for age, sex, race, marital status, primary site, grade, laterality, histology, AJCC stage, radiation, chemotherapy, and type of surgery.