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01-02-2016 | Thoracic Oncology

Gender, Age, and Comorbidity Status Predict Improved Survival with Adjuvant Chemotherapy Following Lobectomy for Non-small Cell Lung Cancers Larger than 4 cm

Authors: Britt J. Sandler, MHS, Zuoheng Wang, PhD, Jacquelyn G. Hancock, MD, Daniel J. Boffa, MD, Frank C. Detterbeck, MD, Anthony W. Kim, MD

Published in: Annals of Surgical Oncology | Issue 2/2016

Abstract

Purpose

To identify pretreatment prognostic factors associated with improved outcomes in patients with non-small cell lung cancer (NSCLC) tumors larger than 4 cm receiving adjuvant chemotherapy following surgery versus surgery alone.

Methods

Information was collected from the National Cancer Data Base on adults diagnosed with NSCLC who underwent lobectomy with or without adjuvant chemotherapy for pathologic T2 tumors measuring at least 4 cm, with no lymph node involvement or distant metastasis. The data were analyzed using model-based recursive partitioning for survival.

Results

Patients who underwent chemotherapy following surgery experienced a survival benefit compared with patients who were treated with surgery alone (5-year survival of 66 vs. 49 %, p < 0.0001). Overall, women had improved 5-year survival relative to men (60 vs. 47 %, p < 0.0001). Despite this observation, three groups of women experienced no benefit from adjuvant chemotherapy: women 65–72 years with a Charlson–Deyo (CD) score ≥1 (5-year survival: 51 vs. 58 %, p = 0.29), women >72 with a CD score = 0 (5-year survival: 53 vs. 56 %, p = 0.57), and women >72 with a CD score ≥1 (5-year survival: 40 vs. 56 %, p = 0.04). By contrast, all groups of men identified by recursive partitioning analysis demonstrated improved survivals with adjuvant chemotherapy.

Conclusions

Adjuvant chemotherapy appears to increase survival for patients with resected NSCLC tumors larger than 4 cm. Women with NSCLC experience improved survival relative to men regardless of treatment. However, there are certain groups of women over 65 years old who do not benefit from adjuvant chemotherapy.

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Title: Gender, Age, and Comorbidity Status Predict Improved Survival with Adjuvant Chemotherapy Following Lobectomy for Non-small Cell Lung Cancers Larger than 4 cm
Authors: Britt J. Sandler, MHS
Zuoheng Wang, PhD
Jacquelyn G. Hancock, MD
Daniel J. Boffa, MD
Frank C. Detterbeck, MD
Anthony W. Kim, MD
Publication date: 01-02-2016
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 2/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-015-4902-8

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Gender, Age, and Comorbidity Status Predict Improved Survival with Adjuvant Chemotherapy Following Lobectomy for Non-small Cell Lung Cancers Larger than 4 cm

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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