{"title":"Adjuvant Chemotherapy After Neoadjuvant Therapy and Surgery for Non-Small Cell Lung Cancer","authors":"","doi":"10.1016/j.atssr.2024.04.033","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>There is a dearth of data on outcomes of postoperative chemotherapy after neoadjuvant therapy followed by surgery in patients with locally advanced non-small cell lung cancer (NSCLC). The objective of this study was to compare survival outcomes in patients who did and did not receive adjuvant chemotherapy.</p></div><div><h3>Methods</h3><p>A retrospective chart review was performed using our multicenter database to identify patients who received neoadjuvant therapy followed by surgery for clinical T3 N0 or N1-N2 resectable NSCLC between 2009 and 2016. Survival outcomes were analyzed with the Kaplan-Meier method and a Cox proportional hazards model. Propensity score matching (PSM) was used to control for selection bias in evaluation of overall survival (OS) and recurrence-free survival (RFS) by matching age, sex, smoking history, Charlson Comorbidity Index, histologic type, and pathologic nodal status and stage.</p></div><div><h3>Results</h3><p>The participants were 156 patients with a median age of 65 years. The median RFS of the whole cohort was 66.3 months; OS was not reached. Before PSM, patients receiving adjuvant chemotherapy had significantly shorter RFS (hazard ratio [HR], 1.79; 95% CI, 1.13-2.82) and showed a trend for shorter OS (HR, 1.37; 95% CI, 0.78-2.39). After PSM, 50 patients were used for comparison in each group, and those receiving adjuvant chemotherapy did not have a more favorable RFS (HR, 1.33; 95% CI, 0.75-2.34) or OS (HR, 1.25; 95% CI, 0.62-2.51).</p></div><div><h3>Conclusions</h3><p>Adjuvant chemotherapy was not associated with favorable survival outcomes in patients treated with surgery after neoadjuvant therapy for locally advanced NSCLC.</p></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772993124002171/pdfft?md5=9982cb6d27063427ff836f70603c302b&pid=1-s2.0-S2772993124002171-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of thoracic surgery short reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772993124002171","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background
There is a dearth of data on outcomes of postoperative chemotherapy after neoadjuvant therapy followed by surgery in patients with locally advanced non-small cell lung cancer (NSCLC). The objective of this study was to compare survival outcomes in patients who did and did not receive adjuvant chemotherapy.
Methods
A retrospective chart review was performed using our multicenter database to identify patients who received neoadjuvant therapy followed by surgery for clinical T3 N0 or N1-N2 resectable NSCLC between 2009 and 2016. Survival outcomes were analyzed with the Kaplan-Meier method and a Cox proportional hazards model. Propensity score matching (PSM) was used to control for selection bias in evaluation of overall survival (OS) and recurrence-free survival (RFS) by matching age, sex, smoking history, Charlson Comorbidity Index, histologic type, and pathologic nodal status and stage.
Results
The participants were 156 patients with a median age of 65 years. The median RFS of the whole cohort was 66.3 months; OS was not reached. Before PSM, patients receiving adjuvant chemotherapy had significantly shorter RFS (hazard ratio [HR], 1.79; 95% CI, 1.13-2.82) and showed a trend for shorter OS (HR, 1.37; 95% CI, 0.78-2.39). After PSM, 50 patients were used for comparison in each group, and those receiving adjuvant chemotherapy did not have a more favorable RFS (HR, 1.33; 95% CI, 0.75-2.34) or OS (HR, 1.25; 95% CI, 0.62-2.51).
Conclusions
Adjuvant chemotherapy was not associated with favorable survival outcomes in patients treated with surgery after neoadjuvant therapy for locally advanced NSCLC.