Table 4.
Distribution of Surgical Morbidity and Univariate Models of Grade 3+ Morbidity
| Variable | Grade 3-4 (n=21) | Grade 5 (n=5) | < Grade 3 Morbidity (n=67) | Grade 3+ Morbidity (n=26) | OR (95% CI) | FDR-adjusted p-value* |
|---|---|---|---|---|---|---|
| Study | ||||||
| 0229 (RL) | 10 (26%) | 1 (2%) | 28 (72%) | 11 (28%) | ||
| 0839 | 11 (20%) | 4 (7%) | 39 (72%) | 15 (28%) | 0.98 (0.39, 2.45) | 0.96 |
| Age | ||||||
| Median | 62 | 61 | 60 | 61.5 | 1.01 (0.96, 1.07) | 0.64 |
| Min-Max | 41-72 | 44-71 | 32-78 | 41-72 | ||
| Q1-Q3 | 56-65 | 52-69 | 53-65 | 54-66 | ||
| Gender | ||||||
| Male (RL) | 9 (17%) | 3 (6%) | 41 (77%) | 12 (23%) | ||
| Female | 12 (30%) | 2 (5%) | 26 (65%) | 14 (35%) | 1.84 (0.74, 4.59) | 0.33 |
| Race | ||||||
| White (RL) | 19 (24%) | 5 (6%) | 55 (70%) | 24 (30%) | ||
| Non-white | 2 (14%) | 0 (0%) | 12 (86%) | 2 (14%) | 0.38 (0.08, 1.84) | 0.33 |
| T-Stage | ||||||
| T1 (RL) | 12 (35%) | 3 (9%) | 19 (56%) | 15 (44%) | ||
| T2/T3 | 9 (15%) | 2 (3%) | 48 (81%) | 11 (19%) | 0.29 (0.11, 0.74) | 0.17 |
| cN2 positive stations | ||||||
| 1 (RL) | 16 (26%) | 4 (7%) | 41 (67%) | 20 (33%) | ||
| 2-4 | 5 (16%) | 1 (3%) | 26 (81%) | 6 (19%) | 0.47 (0.17, 1.33) | 0.33 |
| Tumor location - right vs left | ||||||
| Right-sided (RL) | 17 (25%) | 4 (6%) | 48 (70%) | 21 (30%) | ||
| Left-sided | 4 (17%) | 1 (4 %) | 19 (79%) | 5 (21%) | 0.60 (0.20, 1.83) | 0.48 |
| Tumor location - upper vs lower | ||||||
| Upper lobe (RL) | 13 (21%) | 3 (5%) | 45 (74%) | 16 (26%) | ||
| Lower/Middle lobe | 8 (25%) | 2 (6%) | 22 (69%) | 10 (31%) | 1.28 (0.50, 3.27) | 0.61 |
| Histology | ||||||
| Adenocarcinoma/other (RL) | 14 (19%) | 4 (6%) | 55 (75%) | 18 (25%) | ||
| Squamous | 7 (35%) | 1 (5%) | 12 (60%) | 8 (40%) | 2.04 (0.72, 5.77) | 0.33 |
| FEV1 | ||||||
| Median | 2.16 | 2.24 | 2.41 | 2.20 | 0.75 (0.36, 1.53) | 0.49 |
| Min-Max | 1.28-3.82 | 1.65-3.36 | 1.09-4.13 | 1.28-3.82 | ||
| Q1-Q3 | 1.97-2.85 | 2.16-2.39 | 2.09-2.93 | 1.97-2.85 | ||
| Institution type | ||||||
| Community/VA (RL) | 9 (26%) | 2 (6%) | 23 (68%) | 11 (32%) | ||
| Academic | 12 (20%) | 3 (5%) | 44 (75%) | 15 (25%) | 0.71 (0.28, 1.80) | 0.52 |
| Received Panitumumab | ||||||
| No (RL) | 18 (31%) | 1 (2%) | 39 (67%) | 19 (33%) | ||
| Yes | 3 (9%) | 4 (11%) | 28 (80%) | 7 (20%) | 0.51 (0.19, 1.39) | 0.33 |
| pCR | ||||||
| No (RL) | 15 (21%) | 3 (4%) | 52 (74%) | 18 (26%) | ||
| Yes | 6 (26%) | 2 (9%) | 15 (65%) | 8 (35%) | 1.54 (0.56, 4.24) | 0.49 |
| Mediastinal LN clearance | ||||||
| No (RL) | 6 (23%) | 2 (8%) | 18 (69%) | 8 (31%) | ||
| Yes | 15 (22%) | 3 (5%) | 49 (73%) | 18 (27%) | 0.83 (0.31, 2.23) | 0.71 |
| Days from end of RT to surgery | ||||||
| Median | 48 | 38 | 42 | 44 | 1.02 (0.99, 1.05) | 0.44 |
| Min-Max | 33-119 | 38-47 | 27-106 | 33-119 | ||
| Q1-Q3 | 42-54 | 38-39 | 38-49 | 39-51 | ||
| Extended resection | ||||||
| Lobectomy (RL) | 18 (23%) | 2 (3%) | 57 (74%) | 20 (26%) | ||
| Extended resection | 3 (19%) | 3 (19%) | 10 (62%) | 6 (38%) | 1.71 (0.55, 5.31) | 0.48 |
| Surgical approach | ||||||
| Open (RL) | 18 (23%) | 4 (5%) | 57 (72%) | 22 (28%) | ||
| Minimally invasive | 3 (21%) | 1 (7%) | 10 (71%) | 4 (29%) | 1.04 (0.29, 3.65) | 0.96 |
| RO resection | ||||||
| No (RL) | 0 (0%) | 0 (0%) | 8 (100%) | 0 (0%) | N/A | 0.10† |
| Yes | 21 (25%) | 5 (6%) | 59 (69%) | 26 (31%) | ||
| Surgery duration | ||||||
| Median | 243 | 305 | 233 | 248 | 1.00 (1.00, 1.00) | 0.94 |
| Min-Max | 180-561 | 180-397 | 69-2503 | 180-5641 | ||
| Q1-Q3 | 218-297 | 248-362 | 184-312 | 218-326 | ||
| # mediastinal LN sampled | ||||||
| Median | 3 | 4 | 3 | 3.5 | 1.09 (0.82, 1.44) | 0.58 |
| Min-Max | 1-7 | 1-7 | 0-7 | 1-7 | ||
| # hilar LN sampled | ||||||
| Median | 2 | 2 | 2 | 2 | 0.66 (0.42, 1.03) | 0.25 |
| Min-Max | 0-4 | 1-3 | 0-5 | 0-4 | ||
| Bronchial coverage | ||||||
| No (RL) | 4 (24%) | 0 (0%) | 13 (76%) | 4 (24%) | ||
| Yes | 17 (22%) | 5 (6%) | 54 (71%) | 22 (29%) | 1.32 (0.39, 4.51) | 0.65 |
| Intraoperative transfusion | ||||||
| No (RL) | 18 (22%) | 5 (6%) | 60 (72%) | 23 (28%) | ||
| Yes | 3 (30%) | 0 (0%) | 7 (70%) | 3 (30%) | 1.12 (0.27, 4.70) | 0.88 |
| Estimated blood loss | ||||||
| Median | 175 | 88 | 200 | 150 | 1.00 (1.00, 1.00) | 0.33 |
| Min-Max | 0-500 | 50-300 | 10-2000 | 0-500 | ||
| Q1-Q3 | 100-300 | 50-213 | 100-300 | 87.5-275 | ||
| RTOG 0839 RT Data | Grade 3-4 (n=11) | Grade 5 (n=4) | < Grade 3 Morbidity (n=39) | Grade 3+ Morbidity (n=15) | OR (95% CI) | p-value |
| Lung V5 | ||||||
| Median | 55.9 | 75.0 | 52.9 | 57.7 | 1.03 (1.00, 1.07) | 0.25 |
| Min-Max | 44.0-86.0 | 57.7-88.2 | 19.0-85.1 | 44.0-63.8 | ||
| Q1-Q3 | 49.0-72.9 | 60.8-87.1 | 41.2-67.4 | 34.4-50.6 | ||
| Ipsilateral Lung V10 | ||||||
| Median | 60.9 | 76.2 | 61.1 | 62.9 | 1.03 (1.00, 1.07) | 0.25 |
| Min-Max | 46.1-79.6 | 56.3-95.5 | 26.5-87.0 | 46.1-95.5 | ||
| Q1-Q3 | 50.7-72.2 | 61.1-91.0 | 44.2-72.0 | 51.7-77.5 | ||
| Contralateral Lung V5 | ||||||
| Median | 45.1 | 64.5 | 42.4 | 55.6 | 1.03 (1.00, 1.06) | 0.25 |
| Min-Max | 29.8-85.6 | 49.6-83.0 | 0.5-83.4 | 29.8-85.6 | ||
| Q1-Q3 | 37.4-64.0 | 52.6-78.2 | 24.2-58.2 | 39.8-67.7 | ||
OR, Odds Ratio modeling the risk of developing Grade 3 + Morbidity; RL, Reference level; Q1, first quartile; Q3, third quartile; pCR, pathologic complete response, LN, lymph nodes;
*
FDR, false discovery rate; p<0.25 considered significantly different
†
Fisher’s exact test