Is adjuvant chemotherapy for completely resected p-stage IA (>2 cm) and stage IB non-small-cell lung cancer beneficial for elderly patients? A large, retrospective cohort study based on real-world data from Japan.
Jpn J Clin Oncol
; 53(12): 1191-1200, 2023 Dec 07.
Article
em En
| MEDLINE
| ID: mdl-37626449
ABSTRACT
OBJECTIVE:
The efficacy of tegafur-uracil as adjuvant chemotherapy for patients with completely resected stage I non-small-cell lung cancer is proven; however, its efficacy for elderly patients remains unclear. Herein, we evaluated the effectiveness of adjuvant chemotherapy for elderly patients with completely resected stage I non-small-cell lung cancer based on real-world Japanese data using propensity score matching.METHODS:
This retrospective study extracted data from a nationwide registry study, performed in 2016, on patients ≥75 years who underwent lobectomy with mediastinal nodal dissection for non-small-cell lung cancer in 2010 and were diagnosed with p-stage IA (>2 cm) or stage IB non-small-cell lung cancer. We classified the 1294 patients into two groups-Group A, postoperative adjuvant chemotherapy (n = 295, 22.8%) and Group N, no adjuvant chemotherapy (n = 999, 77.2%)-and analyzed differences in postoperative overall survival between groups.RESULTS:
Group A showed no advantage in overall survival over Group N as a whole (hazard ratio 0.824 [95% confidence interval 0.631-1.076]), in p-stage IA (hazard ratio 0.617 [95% confidence interval 0.330-1.156]) and in p-stage IB (hazard ratio 0.806 [95% confidence interval 0.597-1.088]) subsets. Even after propensity score matching, Group A showed no significant advantage in overall survival over Group N as a whole (hazard ratio 0.975 [95% confidence interval 0.688-1.381]), in p-stage IA (hazard ratio 1.390 [95% confidence interval 0.539-3.586]) and in p-stage IB (hazard ratio 0.922 [95% confidence interval 0.633-1.343]).CONCLUSIONS:
adjuvant chemotherapy for completely resected p-stage IA (>2 cm) and stage IB non-small-cell lung cancer showed no benefit for recommendation for elderly patients; considering the risk of adverse events, we do not recommend adjuvant chemotherapy for elderly patients.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Carcinoma Pulmonar de Células não Pequenas
/
Neoplasias Pulmonares
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article