Surgical Compliance and Survival Outcomes for Patients with Stage T1-2 Non-Small-Cell Lung Cancer.

Introduction: Our aim was to determine the relationship between surgical compliance and survival outcomes in patients with stage T1-2 non-small-cell lung cancer (NSCLC).

Methods: Patients with T1-2 NSCLC who were diagnosed between 2004 and 2015 were identified from the SEER database. Multivariate logistic regression was used to analyse factors associated with surgical compliance. Kaplan-Meier curves and Cox regression were used to analyse the effects of surgical compliance on overall survival (OS) and cancer-specific survival (CSS).

Results: Of the 221,704 eligible T1-2 NSCLC patients, 106,668 patients recommended surgery. Among them, 99,672 (93.4%) patients were surgical compliance group, and 6996 (6.6%) were surgical noncompliance group. Poor surgical compliance was associated with earlier diagnosis time, old age, male, black race, unmarried status, main bronchus site, poor grade/stage, and lower household income. Patients' compliance was an independent prognostic factor for OS and CSS of T1-2 NSCLC patients. Multivariate Cox regression showed that surgical noncompliance individuals showed lower OS (hazard ratio [HR] 2.494; 95% confidence interval [CI] 2.423-2.566, < 0.001) and lower CSS (HR 2.877; 95% CI 2.782-2.974, < 0.001) compared with surgical compliance patients. In addition, results in the non-surgical group were observed to be similar to those of the surgical noncompliance group.

Conclusion: We found that patients' compliance was an independent prognostic factor for survival in T1-2 NSCLC patients. Poor surgical compliance was associated with earlier diagnosis time, old age, male, black race, unmarried status, main bronchus site, poor grade/stage, and lower household income.