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

Authors
 Seong Yong Park  ;  Jin Gu Lee  ;  Jieun Kim  ;  Go Eun Byun  ;  Mi Kyung Bae  ;  Chang Young Lee  ;  Dae Joon Kim  ;  Kyung Young Chung 
Citation
 JOURNAL OF CARDIOTHORACIC SURGERY, Vol.8(1) : 1-8, 2013 
Journal Title
JOURNAL OF CARDIOTHORACIC SURGERY
Issue Date
2013
MeSH
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Area Under Curve ; Carboplatin/administration & dosage ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Carcinoma, Non-Small-Cell Lung/pathology* ; Carcinoma, Non-Small-Cell Lung/surgery ; Chemotherapy, Adjuvant ; Cisplatin/administration & dosage ; Diagnostic Imaging ; Female ; Humans ; Lung Neoplasms/drug therapy* ; Lung Neoplasms/pathology* ; Lung Neoplasms/surgery ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Staging ; Paclitaxel/administration & dosage ; Pneumonectomy ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Outcome ; Vinblastine/administration & dosage ; Vinblastine/analogs & derivatives
Keywords
Lung cancer surgery ; Adjuvant therapy ; Statistics ; Survival analysis
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.
Files in This Item:
T201302810.pdf Download
DOI
10.1186/1749-8090-8-151
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Park, Seong Yong(박성용) ORCID logo https://orcid.org/0000-0002-5180-3853
Bae, Mi Kyung(배미경)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Chung, Kyung Young(정경영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87631
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