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Efficacy of platinum-based adjuvant chemotherapy in T2aN0 stage IB non-small cell lung cancer

Title
 Efficacy of platinum-based adjuvant chemotherapy in T2aN0 stage IB non-small cell lung cancer 
Authors
 Seong Yong Park ; Jin Gu Lee ; Kyung Young Chung ; Dae Joon Kim ; Chang Young Lee ; Mi Kyung Bae ; Go Eun Byun ; Jieun Kim 
Issue Date
2013
Journal Title
 Journal of Cardiothoracic Surgery 
ISSN
 1749-8090 
Citation
 Journal of Cardiothoracic Surgery, Vol.8(1) : 1~8, 2013 
Abstract
BACKGROUND: Although overall survival for non-small cell lung cancer (NSCLC) has increased, survival rate for pathologically staged T2aN0M0 stage IB NSCLC remains low. Adjuvant chemotherapy is not a standard treatment for stage IB NSCLC. Our purpose was to determine the efficacy of platinum-based adjuvant chemotherapy in stage IB NSCLC. METHODS: We retrospectively reviewed the medical records of 119 stage IB patients who underwent lobectomy and mediastinal lymph node dissection. Among these, 60 patients underwent platinum-based adjuvant chemotherapy (adjuvant group) and 59 did not receive chemotherapy (observation group). RESULTS: Participants had a mean age of 62.12 ± 11.51 years and 73 (61.3%) were male. The median follow-up period was 49.04 months. Mean age was higher in the observation group whereas patients in the adjuvant group had larger tumors, more dissected lymph nodes, and better performance status. The 5-year overall survival was 64.7% in the observation group and 88.2% in the adjuvant group (p = 0.010). The 5-year disease-free survival was 51.3% in the observation group and 74.0% in the adjuvant group (p = 0.011). In multivariate analysis, only platinum-based adjuvant chemotherapy was a risk factor for overall survival [hazard ratio (HR) = 0.428, p = 0.049] and disease-free survival (HR = 0.57, p = 0.043). In subset analysis, patients with a larger tumor (greater than 3.2 cm), moderate to poor differentiation, and good performance status (Eastern Cooperative Oncology Group, 0) benefitted from platinum-based adjuvant chemotherapy. CONCLUSIONS: Platinum-based adjuvant chemotherapy for surgically treated stage IB NSCLC might offer better survival than observation alone. A large-scale randomized clinical trial is needed to validate these findings.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87631
DOI
10.1186/1749-8090-8-151
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Thoracic & Cardiovascular Surgery
Yonsei Authors
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