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Published in: Journal of Cardiothoracic Surgery 1/2024

Open Access 01-12-2024 | NSCLC | Research

Influence of adjuvant chemotherapy on survival for patients with completely resected high-risk stage IB NSCLC

Authors: Zi-Qing Shen, Kun-Peng Feng, Zi-Yao Fang, Tian Xia, Shu Pan, Cheng Ding, Chun Xu, Sheng Ju, Jun Chen, Chang Li, Jun Zhao

Published in: Journal of Cardiothoracic Surgery | Issue 1/2024

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Abstract

Background

The use of adjuvant chemotherapy (ACT) in completely resected stage IB NSCLC is still controversial. This study aims to investigate the efficacy of ACT in pathological stage IB non-small cell lung cancer (NSCLC) with high risk factors.

Methods

Patients with pT2aN0M0 stage IB NSCLC who underwent complete resection from 2013 to 2017 were retrospectively analyzed. Univariate and multivariable logistic regression analysis was used to assess potential independent risk factors associated with poor prognosis. To compare survival between patients who received ACT and those who did not.

Results

In univariate and multivariate analyses, adenocarcinomas with predominantly micropapillary (MIP) and solid patterns (SOL), poorly differentiated squamous cell carcinoma (SCC), number of lymph nodes dissected less than 16 and tumor size larger than 36 mm were identified as high-risk factors for recurrence. In patients with high risk factors for recurrence, ACT resulted in significantly longer DFS (HR, 0.4689, 95%CI, 1.193–3.818; p = 0.0108) and OS (HR, 0.4696, 95%CI, 0.6578–6.895; p = 0.2073), although OS failed to reach statistically significance. After propensity score matching (PSM), 67 pairs of patients were 1:1 matched in the two groups and all baseline characteristics were well balanced. The results also demonstrated that ACT was associated with improved DFS (HR, 0.4776, 95%CI, 0.9779–4.484; p = 0.0440) while OS was not significantly different (92.5% vs. 91.0%; HR, 0.6167, 95%CI, 0.1688–2.038; p = 0.7458). In patients with low-risk factors for recurrence, DFS (HR, 0.4831, 95%CI, 0.03025-7.715; p = 0.6068) and OS (HR, 0.969, 95%CI, 0.08364-11.21; p = 0.9794) was not significantly different between those who received ACT and those who did not.

Conclusion

In patients with completely resected stage IB NSCLC, ACT can improve survival in patients with high risk for recurrence. Further large multicenter studies are needed to confirm these findings.
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Metadata
Title
Influence of adjuvant chemotherapy on survival for patients with completely resected high-risk stage IB NSCLC
Authors
Zi-Qing Shen
Kun-Peng Feng
Zi-Yao Fang
Tian Xia
Shu Pan
Cheng Ding
Chun Xu
Sheng Ju
Jun Chen
Chang Li
Jun Zhao
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2024
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-023-02457-1

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