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Benefit of adjuvant chemotherapy after resection of stage II (T1-2N1M0) non-small cell lung cancer in elderly patients.

Publication ,  Journal Article
Berry, MF; Coleman, BK; Curtis, LH; Worni, M; D'Amico, TA; Akushevich, I
Published in: Ann Surg Oncol
February 2015

BACKGROUND: We evaluated the use and efficacy of adjuvant chemotherapy after resection of T1-2N1M0 non-small cell lung cancer (NSCLC) in elderly patients. METHODS: Factors associated with the use of adjuvant chemotherapy in patients older than 65 years of age who underwent surgical resection of T1-2N1M0 NSCLC without induction chemotherapy or radiation in the Surveillance, Epidemiology, and End Results-Medicare database from 1992 to 2006 were assessed using a multivariable logistic regression model that included treatment, patient, tumor, and census tract characteristics. Overall survival (OS) was analyzed using the Kaplan-Meier approach and inverse probability weight-adjusted Cox proportional hazard models. RESULTS: Overall, 2,781 patients who underwent surgical resection as the initial treatment for T1-2N1M0 NSCLC and survived at least 31 days after surgery were identified, with adjuvant chemotherapy given to 784 patients (28.2 %). Factors that predicted adjuvant chemotherapy use were younger age and higher T status. The 5-year OS was significantly better for patients who received adjuvant chemotherapy compared with patients not given adjuvant chemotherapy: 35.8 % (95 % confidence interval [CI] 31.9-39.6) vs. 28.0 % (95 % CI 25.9-30.0) (p = 0.008). In the inverse probability weight-adjusted Cox proportional hazard regression model, adjuvant chemotherapy use predicted significantly improved survival (hazard ratio 0.84; 95 % CI 0.76-0.92; p = 0.0002). CONCLUSIONS: Adjuvant chemotherapy after resection of T1-2N1M0 NSCLC is associated with significantly improved survival in patients older than 65 years. These data can be used to provide elderly patients with realistic expectations of the potential benefits when considering adjuvant chemotherapy in this setting.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

February 2015

Volume

22

Issue

2

Start / End Page

642 / 648

Location

United States

Related Subject Headings

  • Survival Analysis
  • SEER Program
  • Retrospective Studies
  • Pneumonectomy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Male
  • Lung Neoplasms
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Berry, M. F., Coleman, B. K., Curtis, L. H., Worni, M., D’Amico, T. A., & Akushevich, I. (2015). Benefit of adjuvant chemotherapy after resection of stage II (T1-2N1M0) non-small cell lung cancer in elderly patients. Ann Surg Oncol, 22(2), 642–648. https://doi.org/10.1245/s10434-014-4056-0
Berry, Mark F., Brooke K. Coleman, Lesley H. Curtis, Mathias Worni, Thomas A. D’Amico, and Igor Akushevich. “Benefit of adjuvant chemotherapy after resection of stage II (T1-2N1M0) non-small cell lung cancer in elderly patients.Ann Surg Oncol 22, no. 2 (February 2015): 642–48. https://doi.org/10.1245/s10434-014-4056-0.
Berry MF, Coleman BK, Curtis LH, Worni M, D’Amico TA, Akushevich I. Benefit of adjuvant chemotherapy after resection of stage II (T1-2N1M0) non-small cell lung cancer in elderly patients. Ann Surg Oncol. 2015 Feb;22(2):642–8.
Berry, Mark F., et al. “Benefit of adjuvant chemotherapy after resection of stage II (T1-2N1M0) non-small cell lung cancer in elderly patients.Ann Surg Oncol, vol. 22, no. 2, Feb. 2015, pp. 642–48. Pubmed, doi:10.1245/s10434-014-4056-0.
Berry MF, Coleman BK, Curtis LH, Worni M, D’Amico TA, Akushevich I. Benefit of adjuvant chemotherapy after resection of stage II (T1-2N1M0) non-small cell lung cancer in elderly patients. Ann Surg Oncol. 2015 Feb;22(2):642–648.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

February 2015

Volume

22

Issue

2

Start / End Page

642 / 648

Location

United States

Related Subject Headings

  • Survival Analysis
  • SEER Program
  • Retrospective Studies
  • Pneumonectomy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Male
  • Lung Neoplasms
  • Humans
  • Female