Impact of treatment-related complications on long-term outcomes in recurrence-free survivors with locally advanced non-small cell lung cancer after Trimodality therapy.

OBJECTIVES: Trimodality therapy, consisting of induction chemoradiotherapy followed by surgery, remains a viable treatment option for locally advanced non-small cell lung cancer (LA-NSCLC). However, because this approach constitutes highly intensive local therapy, late adverse events may contribute to long-term, non-cancer-related outcomes. This study sought to clarify the prognostic impact of these events in recurrence-free patients treated with trimodality therapy. METHODS: We conducted a retrospective analysis of patients who underwent trimodality therapy from January 1999 to December 2021 and remained recurrence-free during the follow-up. RESULTS: Of the 199 patients who received trimodality therapy, 112 (56.3%) remained recurrence-free and were included in this analysis. Their median age at surgery was 62.5 years. The clinical stages were stage II (n = 27), stage III (n = 85). The median follow-up was 11.5 years, and the overall survival rates among patients without recurrence at 3, 5, and 10 years were 90.0%, 84.4%, and 71.5%, respectively. Multivariable analysis showed chronic lung injury extending beyond the anatomical segment (P = 0.04) was independent prognostic factors. CONCLUSIONS: We observed an association between treatment-related pulmonary morbidity and long-term survival among recurrence-free patients after trimodality therapy. These findings suggest that minimizing treatment-related complications may be important for long-term outcomes.