New research presented at the American Thoracic Society 2025 International Conference highlights the limited impact of postoperative radiation therapy (PORT) on offsetting the survival decrement after incomplete resection non-small cell lung carcinoma (NSCLC).
“PORT has been shown to improve survival in such patients. However, it is unclear how much of the survival detriment of incomplete resection PORT can offset compared to negative margins,” wrote the authors, led by F. Khan of Yale New Haven Health Bridgeport in Connecticut.
They explored theSurveillance, Epidemiology, and End Results (SEER) database to identify all cases of microscopically confirmed NSCLC that were diagnosed from 2010 to 2017. Cases had to involve T1-4, N0, M0 staging; chemotherapy; and surgical resection. The study split patients into one of two groups, each containing 386 patients: margin-positive (received PORT) and margin-negative (did not receive PORT).
The PORT group had a significantly lower five-year cancer-specific survival (CSS) rate than the no-PORT group (48% versus 65%). Furthermore, the PORT group had a higher adjusted hazard ratio for cancer-specific mortality, even after the researchers controlled for age, grade, marital status, and race. Finally, patients with more advanced T stages and higher tumor grades had poorer survival outcomes.
The authors said their findings indicate that PORThas limited ability to offset survival decrement after incomplete resection. Therefore, “Every attempt should be made to achieve a complete surgical resection of the primary tumor,” they wrote.
Reference Khan F, Ayaz S, Saleh RHN, et al. Impact of Post-operative Radiation Therapy on Survival in NSCLC Patients With Incomplete Surgical Resection. Abstract #A2715. Presented at the American Thoracic Society International Conference; May 18-21, 2025; San Francisco, California.
