Cancer Res Treat.  2017 Oct;49(4):898-905. 10.4143/crt.2016.312.

Effect of Adjuvant Chemotherapy after Complete Resection for Pathologic Stage IB Lung Adenocarcinoma in High-Risk Patients as Defined by a New Recurrence Risk Scoring Model

• Jang HJ
• Cho S
• Kim K
• Jheon S
• Yang HC
• Kim DK

• KMID: 2394809
• DOI: http://doi.org/10.4143/crt.2016.312

Abstract

PURPOSE
We conducted a retrospective analysis to determine if adjuvant chemotherapy prolongs overall survival in patients with pathologic stage IB lung adenocarcinoma who had undergone complete resection and were defined as high-risk by a newly developed recurrence risk scoring model.
MATERIALS AND METHODS
Patients who underwent curative resection for stage IB lung adenocarcinoma were analyzed with a newly developed recurrence risk scoring model and divided into a low-risk group and a high-risk group. The patients in the high-risk group were retrospectively divided into two groups based on whether they underwent adjuvant chemotherapy or observation. Recurrence-free survival and overall survival were compared between these two groups.
RESULTS
A total of 328 patients who underwent curative resection between 2000 and 2009 were included in this study, of whom 110 (34%) received adjuvant chemotherapy and 218 (67%) underwent observation without additional treatment. According to our risk model, 167 patients (51%) were high-risk and 161 (49%) were low-risk. The 5-year recurrence-free survival rates and overall survival were 84.4% and 91.5% in low-risk patients and 53.9% and 74.7% in high-risk patients (p < 0.001). In high-risk patients, the 5-year overall survival rates were 77% among patients who underwent observation and 87% among those who underwent adjuvant chemotherapy (p=0.019).
CONCLUSION
Adjuvant chemotherapy prolonged overall survival among high-risk patients who had undergone complete resection for stage IB lung adenocarcinoma.

Keyword

Adjuvant chemotherapy; Stage IB; Adenocarcinoma; High risk

MeSH Terms

Adenocarcinoma*
Chemotherapy, Adjuvant*
Humans
Lung*
Recurrence*
Retrospective Studies
Survival Rate

Figure

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  Fig. 1. Kaplan-Meier estimates of recurrence-free survival (A) and overall survival (B) between low-risk and high-risk patients. (A) The 5-year recurrence-free survival rates were 84.4% in low-risk patients and 53.9% in high-risk patients. (B) The 5-year overall survival rates were 91.5% in low-risk patients and 74.7% in high-risk patients.

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  Fig. 2. Kaplan-Meier estimates of overall survival between observation and chemotherapy. The 5-year overall survival rate was 79% in patients who received observation and 92% in those who received chemotherapy.

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  Fig. 3. Kaplan-Meier estimates of overall survival between observation and chemotherapy in low-risk (A) and high-risk (B) patients. (A) The 5-year overall survival rate was 89% in patients with observation and 96% for those who received chemotherapy in high-risk patients. (B) The 5-year overall survival rate was 77% in patients who received observation and 87% in those who received chemotherapy in high-risk patients.

Reference

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