Abstract
BACKGROUND: In this study, we aimed to compare the outcomes of patients who underwent surgery after neoadjuvant chemoradiotherapy versus primary surgery in locally advanced T4 non-small cell lung cancer. METHODS: Between January 2010 and January 2020, a total of 71 non-small cell lung cancer patients (63 males, 8 females; mean age: 57.9±9.6 years; range, 34 to 76 years) diagnosed with T4 tumors and underwent surgery were retrospectively analyzed. Of these patients, 50 underwent neoadjuvant therapy before surgical resection (Group 1), while 21 underwent surgical resection alone (Group 2). Demographic characteristics, complications, mortality and pathological examination results of the patients were recorded. RESULTS: The neoadjuvant therapy group exhibited a significantly lower mortality rate (odds ratio=4.3). Age and neoadjuvant treatment were the most significant factors on mortality. Overall survival was longer among patients receiving neoadjuvant chemoradiotherapy, but not statistically significant (80.5±9.9 months vs. 60.9±7.9 months, p=0.081). CONCLUSION: Our study results indicated a substantial reduction in mortality rates among patients with T4 tumors who underwent concurrent neoadjuvant chemoradiotherapy. Based on these results, neoadjuvant treatment serves as a beneficial preoperative intervention for eligible patients and should be considered before surgical resection.