Adjuvant Chemotherapy Improves the Probability of Freedom From Recurrence in Patients With Resected Stage IB Lung Adenocarcinoma

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• 作者：Jung-Jyh Hung ; MD ; PhD^a ; ^&lowast ; ; Yu-Chung Wu ; MD^a ; Teh-Ying Chou ; MD ; PhD^b ; ^c ; Wen-Juei Jeng ; MD^c ; ^d ; Yi-Chen Yeh ; MD^b ; ^c ; Wen-Hu Hsu ; MD^a ; ^&lowast ; ; ^{whhsu@vghtpe.gov.tw" class="auth_mail" title="E-mail the corresponding author}
• 刊名：The Annals of Thoracic Surgery
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：101
• 期：4
• 页码：1346-1353
• 全文大小：508 K

文摘

The benefit of adjuvant chemotherapy remains controversial for patients with stage IB non–small-cell lung cancer (NSCLC). This study investigated the effect of adjuvant chemotherapy and the predictors of benefit from adjuvant chemotherapy in patients with stage IB lung adenocarcinoma.

Methods

A total of 243 patients with completely resected pathologic stage IB lung adenocarcinoma were included in the study. Predictors of the benefits of improved overall survival (OS) or probability of freedom from recurrence (FFR) from platinum-based adjuvant chemotherapy in patients with resected stage IB lung adenocarcinoma were investigated.

Results

Among the 243 patients, 70 (28.8%) had received platinum-based doublet adjuvant chemotherapy. A micropapillary/solid–predominant pattern (versus an acinar/papillary–predominant pattern) was a significantly worse prognostic factor for probability of FFR (p = 0.033). Although adjuvant chemotherapy (versus surgical intervention alone) was not a significant prognostic factor for OS (p = 0.303), it was a significant prognostic factor for a better probability of FFR (p = 0.029) on multivariate analysis. In propensity-score–matched pairs, there was no significant difference in OS between patients who received adjuvant chemotherapy and those who did not (p = 0.386). Patients who received adjuvant chemotherapy had a significantly better probability of FFR than those who did not (p = 0.043). For patients with a predominantly micropapillary/solid pattern, adjuvant chemotherapy (p = 0.033) was a significant prognostic factor for a better probability of FFR on multivariate analysis.

Conclusions

Adjuvant chemotherapy is a favorable prognostic factor for the probability of FFR in patients with stage IB lung adenocarcinoma, particularly in those with a micropapillary/solid–predominant pattern.