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Clinical efficacy of adjuvant chemotherapy in stage IB (< 4 cm) non-small cell lung cancer patients with high-risk factors

BACKGROUND/AIMS: Adjuvant chemotherapy is the standard of care for resected stage II–IIIA non-small cell lung cancer (NCSLC). The efficacy of adjuvant chemotherapy in stage IB (< 4 cm) NSCLC with high-risk factors is controversial. METHODS: This retrospective multicenter study included 285 stage...

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Autores principales: Choi, Juwhan, Oh, Jee Youn, Lee, Young Seok, Min, Kyung Hoon, Shim, Jae Jeong, Choi, Sue In, Park, Dong Won, Park, Chan Kwon, Kang, Eun Joo, Yong, Hwan Seok, Shin, Bong Kyung, Kim, Hyun Koo, Lee, Sung Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Association of Internal Medicine 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8747921/
https://www.ncbi.nlm.nih.gov/pubmed/32872735
http://dx.doi.org/10.3904/kjim.2020.011
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author Choi, Juwhan
Oh, Jee Youn
Lee, Young Seok
Min, Kyung Hoon
Shim, Jae Jeong
Choi, Sue In
Park, Dong Won
Park, Chan Kwon
Kang, Eun Joo
Yong, Hwan Seok
Shin, Bong Kyung
Kim, Hyun Koo
Lee, Sung Yong
author_facet Choi, Juwhan
Oh, Jee Youn
Lee, Young Seok
Min, Kyung Hoon
Shim, Jae Jeong
Choi, Sue In
Park, Dong Won
Park, Chan Kwon
Kang, Eun Joo
Yong, Hwan Seok
Shin, Bong Kyung
Kim, Hyun Koo
Lee, Sung Yong
author_sort Choi, Juwhan
collection PubMed
description BACKGROUND/AIMS: Adjuvant chemotherapy is the standard of care for resected stage II–IIIA non-small cell lung cancer (NCSLC). The efficacy of adjuvant chemotherapy in stage IB (< 4 cm) NSCLC with high-risk factors is controversial. METHODS: This retrospective multicenter study included 285 stage IB NSCLC patients with high-risk factors according to the 8th edition tumor, node, metastasis (TNM) classification from four academic hospitals. High-risk factors included visceral pleural invasion, vascular invasion, lymphatic invasion, lung neuroendocrine tumors, and micropapillary histology patterns. RESULTS: Of the 285 patients, 127 (44.6%) were included in the adjuvant chemotherapy group and 158 (55.4%) were included in the non-adjuvant chemotherapy group. The median follow-up was 41.5 months. Patients in the adjuvant chemotherapy group had a significantly reduced recurrence rate and risk of mortality than those in the non-adjuvant chemotherapy group (hazards ratio, 0.408; 95% confidence interval, 0.221 to 0.754; p = 0.004 and hazards ratio, 0.176; 95% confidence interval, 0.057 to 0.546; p = 0.003, respectively). Adjuvant chemotherapy should be particularly considered for the high-risk factors such as visceral pleural involvement or vascular invasion. Based on the subgroup analysis, adjuvant chemotherapy should be considered when visceral pleural involvement is present, even if the tumor size is < 3 cm. CONCLUSIONS: Adjuvant chemotherapy may be useful for patients with stage IB NSCLC with high-risk factors and is more relevant for patients with visceral pleural involvement or vascular invasion.
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spelling pubmed-87479212022-01-18 Clinical efficacy of adjuvant chemotherapy in stage IB (< 4 cm) non-small cell lung cancer patients with high-risk factors Choi, Juwhan Oh, Jee Youn Lee, Young Seok Min, Kyung Hoon Shim, Jae Jeong Choi, Sue In Park, Dong Won Park, Chan Kwon Kang, Eun Joo Yong, Hwan Seok Shin, Bong Kyung Kim, Hyun Koo Lee, Sung Yong Korean J Intern Med Original Article BACKGROUND/AIMS: Adjuvant chemotherapy is the standard of care for resected stage II–IIIA non-small cell lung cancer (NCSLC). The efficacy of adjuvant chemotherapy in stage IB (< 4 cm) NSCLC with high-risk factors is controversial. METHODS: This retrospective multicenter study included 285 stage IB NSCLC patients with high-risk factors according to the 8th edition tumor, node, metastasis (TNM) classification from four academic hospitals. High-risk factors included visceral pleural invasion, vascular invasion, lymphatic invasion, lung neuroendocrine tumors, and micropapillary histology patterns. RESULTS: Of the 285 patients, 127 (44.6%) were included in the adjuvant chemotherapy group and 158 (55.4%) were included in the non-adjuvant chemotherapy group. The median follow-up was 41.5 months. Patients in the adjuvant chemotherapy group had a significantly reduced recurrence rate and risk of mortality than those in the non-adjuvant chemotherapy group (hazards ratio, 0.408; 95% confidence interval, 0.221 to 0.754; p = 0.004 and hazards ratio, 0.176; 95% confidence interval, 0.057 to 0.546; p = 0.003, respectively). Adjuvant chemotherapy should be particularly considered for the high-risk factors such as visceral pleural involvement or vascular invasion. Based on the subgroup analysis, adjuvant chemotherapy should be considered when visceral pleural involvement is present, even if the tumor size is < 3 cm. CONCLUSIONS: Adjuvant chemotherapy may be useful for patients with stage IB NSCLC with high-risk factors and is more relevant for patients with visceral pleural involvement or vascular invasion. Korean Association of Internal Medicine 2022-01 2021-07-29 /pmc/articles/PMC8747921/ /pubmed/32872735 http://dx.doi.org/10.3904/kjim.2020.011 Text en Copyright © 2022 The Korean Association of Internal Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Choi, Juwhan
Oh, Jee Youn
Lee, Young Seok
Min, Kyung Hoon
Shim, Jae Jeong
Choi, Sue In
Park, Dong Won
Park, Chan Kwon
Kang, Eun Joo
Yong, Hwan Seok
Shin, Bong Kyung
Kim, Hyun Koo
Lee, Sung Yong
Clinical efficacy of adjuvant chemotherapy in stage IB (< 4 cm) non-small cell lung cancer patients with high-risk factors
title Clinical efficacy of adjuvant chemotherapy in stage IB (< 4 cm) non-small cell lung cancer patients with high-risk factors
title_full Clinical efficacy of adjuvant chemotherapy in stage IB (< 4 cm) non-small cell lung cancer patients with high-risk factors
title_fullStr Clinical efficacy of adjuvant chemotherapy in stage IB (< 4 cm) non-small cell lung cancer patients with high-risk factors
title_full_unstemmed Clinical efficacy of adjuvant chemotherapy in stage IB (< 4 cm) non-small cell lung cancer patients with high-risk factors
title_short Clinical efficacy of adjuvant chemotherapy in stage IB (< 4 cm) non-small cell lung cancer patients with high-risk factors
title_sort clinical efficacy of adjuvant chemotherapy in stage ib (< 4 cm) non-small cell lung cancer patients with high-risk factors
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8747921/
https://www.ncbi.nlm.nih.gov/pubmed/32872735
http://dx.doi.org/10.3904/kjim.2020.011
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