- Adjuvant chemotherapy (ACT) may improve survival in patients with pathological stage I NSCLC who have high risk factors for recurrence.
Why this matters
- Use of ACT in stage I NSCLC is controversial.
- This study investigated benefit in certain tumors with high-risk factors for recurrence.
- 1278 patients with pathological stage I NSCLC undergoing lobectomy were prospectively analyzed for high-risk factors and retrospectively analyzed for differential recurrence-free survival (RFS), OS, and cancer-specific survival (CSS) with and without ACT.
- High-risk factors are defined as invasive component size >2 cm, lymphatic permeation, vascular invasion, or visceral pleural invasion.
- 305 patients received ACT; 37.4% received platinum doublets, and 62.6% received monotherapy with oral fluoropyrimidines or others.
- The high-risk group (n=641) had significantly worse RFS (P<.0001 and os than the low-risk group.>
- Low-risk group: ACT showed no significant benefit in RFS (P=.30), OS (P=.35), or CSS (P=.52).
- High-risk group: ACT yielded significant benefit in RFS (P=.023), OS (P<.0001 and css>