Clinical efficacy of adjuvant chemotherapy in stage IB (< 4 cm) non-small cell lung cancer patients with high-risk factorsopen access
- Authors
- 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
- Issue Date
- Jan-2022
- Publisher
- 대한내과학회
- Keywords
- Carcinoma; non-small-cell lung; Surgery; Chemotherapy; adjuvant; Risk factor
- Citation
- The Korean Journal of Internal Medicine, v.37, no.1, pp 127 - 136
- Pages
- 10
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- The Korean Journal of Internal Medicine
- Volume
- 37
- Number
- 1
- Start Page
- 127
- End Page
- 136
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/55121
- DOI
- 10.3904/kjim.2020.011
- ISSN
- 1226-3303
2005-6648
- Abstract
- 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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- Appears in
Collections - 2. Clinical Science > Department of Thoracic and Cardiovascular Surgery > 1. Journal Articles
- 2. Clinical Science > Department of Pathology > 1. Journal Articles
- 2. Clinical Science > Department of Radiology > 1. Journal Articles
- 2. Clinical Science > Department of Medical Oncology and Hematology > 1. Journal Articles
- 2. Clinical Science > Department of Pulmonary, Allergy, and Critical Care Medicine > 1. Journal Articles
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