- Patients with indeterminate margins following surgical resection for NSCLC had worse OS than those with negative margins, despite the receipt of adjuvant therapy.
Why this matters
- Surgical NSCLC patients with indeterminate margins may not be good candidates for adjuvant therapy, given its high toxicity and lack of OS benefit in these patients.
- 232,986 stage I NSCLC patients from the National Cancer Database underwent surgical resection.
- Funding: None disclosed.
- 0.31% of patients had indeterminate margins.
- Anatomic resection was independently associated with decreased risk of indeterminate margins (segmentectomy HR, 0.48; P<.001 lobectomy hr p and pneumonectomy>
- 5-year OS was 34% in patients with indeterminate margins vs 56% in margin-negative patients (HR, 1.53; P<.001 for worse survival>
- Indeterminate margins were associated with worse OS in patients with stage I disease (HR, 1.66; P<.001 and stage iii p compared with margin-negative patients.>
- Among patients with indeterminate margins, 62% received no adjuvant therapy, 17% adjuvant chemotherapy, 6% adjuvant radiation, and 15% adjuvant chemoradiation.
- After multivariable analysis, patients with indeterminate margins had worse OS than margin-negative patients whether they had adjuvant therapy (HR, 1.51; P<.001 or not p>
- Retrospective study.