O-033 * PATIENTS WITH STAGE IIIA (N2) NON-SMALL-CELL LUNG CANCER SELECTED FOR NEOADJUVANT CHEMORADIATION AND SURGERY HAVE IMPROVED SURVIVAL COMPARED TO PATIENTS TREATED WITH DEFINITIVE CHEMORADIATION
Bibliographic record
Abstract
Objectives: The objective of this study was to compare survival in patients with stage IIIA (N2) non-small-cell lung cancer (NSCLC) selected for treatment with definitive chemoradiation who may have been operative candidates or chemoradiation followed by surgery in a centre with experience in surgery after chemoradiation. Methods: A retrospective analysis of patients with stage IIIA (N2) NSCLC treated with curative intent at a single centre between 1997 and 2007. Survival outcomes were analyzed using Cox proportional hazards model, log-rank test and Kaplan-Meier methodology. Time to recurrence was compared using the proportional subdistribution hazards regression model, Gray's test and cumulative incidence functions. Survival outcomes and recurrences were compared in regression models adjusting for age at diagnosis, cell type, ECOG status, gender and smoking history. Regression models adjusted for a measure of the likelihood of having surgery (the propensity score) were also determined. Results: Between 1997 and 2007, 199 patients with a median age of 61, were treated with chemoradiation followed by surgery (91) or chemoradiation (108). In the surgery group 71 (78%) had a lobectomy. Surgical patients were more likely to be younger (P = 0.045), female (P = 0.045), T1N2 (23% vs 19%) and less likely to be T3N2 (10% vs 20%). Surgical patients had decreased disease recurrence at any location (HR= 0.49; 95% CI 0.34-0.71, P = 0.0002), locoregional recurrence (HR= 0.52; 95% CI 0.2-0.84, P = 0.007), and increased time to distant recurrence (HR= 0.65; 95% CI 0.41-1.3, P = 0.07) with a median survival of 3.4 years compared to 1.7 years for the non-surgical patients (HR = 0.53, 95% CI 0.38-0.76, P = 0.0005). The propensity score adjusted for overall survival was 0.56 (95% CI 0.39-0.79, P = 0.001). Mortality was 6 (6.8%) in the surgery group and 3 (3.2%) in the nonsurgery group. Conclusions: For carefully selected patients with stage IIIA (N2) NSCLC, neoadjuvant chemoradiation followed by surgery offers prolonged survival and time to recurrence. Disclosure: No significant relationships.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".