肿瘤分化是许多癌症辅助治疗的重要指标，然而非小细胞肺癌（NSCLC）是个例外。此外，关于N0-1和N2期NSCLC患者是否进行术后放疗（PORT）存在争议。我们旨在评估肿瘤相关因素对完全切除的III期A期NSCLC患者的总生存期（OS）、癌特异性生存期（CSS）和远处控制（DC）的影响。 从台湾癌症登记处（2007年1月至2017年12月）中找到了接受完全切除和辅助化疗的非转移性III期A期非小细胞肺癌（NSCLC）患者。进行逻辑回归分析以确定与PORT相关的因素。通过对数秩检验和Cox回归分析比较生存和复发结果。使用倾向评分匹配对进行敏感性分析。 总计1,897名患者被纳入研究，并根据是否接受PORT分为PORT组和非PORT组。在调整混杂因素后，发现PORT与改善生存结果无关。在肿瘤分化差和N2病情的患者中，观察到OS的绝对益处（调整风险比[aHR] 0.76），CSS的绝对益处（aHR 0.80）和DC的绝对益处（aHR 0.74）。对配对倾向评分pN2病情和肿瘤分化差亚组的多变量风险模型也显示出PORT治疗的显著生存益处。 在III期A期NSCLC完全切除的肿瘤分化差患者中，接受PORT治疗的pN2病情显示出较低的远处复发风险和较好的生存结果。 版权所有©2023 Elsevier B.V.发表。

Tumour differentiation is an important index for adjuvant therapy in many cancers; however, non-small cell lung cancer (NSCLC) is an exception. Furthermore, postoperative radiotherapy (PORT) is controversial in patients with NSCLC with N0-1 and N2 disease. We aimed to evaluate the impact of tumour-related factors on overall survival (OS), cancer-specific survival (CSS), and distant control (DC) in patients with completely resected stage IIIA NSCLC.Patients with stage IIIA non-metastatic NSCLC who underwent complete resection and adjuvant chemotherapy were identified from the Taiwan Cancer Registry (January 2007-December 2017). Logistic regression analysis was performed to determine the factors associated with PORT. Survival and relapse outcomes were compared using log-rank tests and Cox regression analysis. Sensitivity analysis was performed using propensity score-matched pairs.In total, 1,897 patients were included and stratified according to PORT use (PORT vs. non-PORT). After adjusting for covariates, PORT was not found to be associated with improved survival outcomes. In patients with poorly differentiated tumours and N2 disease, absolute benefits for OS (adjusted hazard ratio [aHR] 0.76), CSS (aHR 0.80), and DC (aHR 0.74) were observed. Multivariable hazard models of propensity score-matched pN2 disease and poorly differentiated tumour subgroups also showed significant survival benefit with PORT treatment.Patients with poorly differentiated tumours and receiving PORT for pN2 disease showed a lower risk of distant recurrence and more favourable survival outcomes in stage IIIA NSCLC with R0 resection.Copyright © 2023. Published by Elsevier B.V.