Adjuvant chemotherapy could improve the prognosis of stage II–III non-small cell lung cancer (NSCLC). However, its influences on stage IB were controversial. The purpose of this study was to investigate whether patients with stage IB NSCLC could benefit from adjuvant chemotherapy.
Stage IB NSCLC in 2010–2015 was selected from the surveillance, epidemiology, and end result database. Chi square test was used to compare the clinical characteristics of patients with different adjuvant chemotherapy status. Kaplan–Meier survival curves were plotted by the log-rank test. Cox proportional hazard regression was used to perform multivariate analysis on overall survival (OS), and the life table method was employed to calculate 1-, 3-, and 5-year survival rates.
A total of 2915 patients were included in this study, and the number of patients with visceral pleural invasion (VPI) was 1096 (37.6%), of which 145 (13.2%) received adjuvant chemotherapy. There was no statistical difference in OS among the total population with or without chemotherapy (p = 0.295), nor in patients with VPI (p = 0.216). In patients with VPI, the 1-, 3-, 5-year survival curves of patients who are receiving adjuvant chemotherapy showed an upward trend compared with patients who did not. Additionally, female, high differentiated, adenocarcinoma, and tumor size ≤ 3 cm were also independent prognostic factors for improving the prognosis of patients with VPI.
In our study, stage IB NSCLC did not benefit from adjuvant chemotherapy, even in patients with VPI. However, the significance of adjuvant chemotherapy in patients with VPI is still worth further exploration.
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Adachi H et al (2015) Influence of visceral pleural invasion on survival in completely resected non-small-cell lung cancer. Eur J Cardiothorac Surg 48(5):691–697 (discussion 697)
Bray F et al (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424
Burdett S et al (2015) Adjuvant chemotherapy for resected early-stage non-small cell lung cancer. Cochrane Database Syst Rev 3:CD011430
Butts CA et al (2010) Randomized phase III trial of vinorelbine plus cisplatin compared with observation in completely resected stage IB and II non-small-cell lung cancer: updated survival analysis of JBR-10. J Clin Oncol 28(1):29–34
Chang YL et al (2012) The significance of visceral pleural surface invasion in 321 cases of non-small cell lung cancers with pleural retraction. Ann Surg Oncol 19(9):3057–3064
Holmes EC (1994) Surgical adjuvant therapy for stage II and stage III adenocarcinoma and large cell undifferentiated carcinoma. Chest 106(6 Suppl):293S–296S
Huang H et al (2015) Visceral pleural invasion remains a size-independent prognostic factor in stage I non-small cell lung cancer. Ann Thorac Surg 99(4):1130–1139
Hung JJ et al (2010) Prognostic factors in pathological stage IB nonsmall cell lung cancer greater than 3 cm. Eur Respir J 36(6):1355–1361
Hung JJ et al (2016) Adjuvant chemotherapy improves the probability of freedom from recurrence in patients with resected stage IB lung adenocarcinoma. Ann Thorac Surg 101(4):1346–1353
Jang HJ et al (2017) Effect of adjuvant chemotherapy after complete resection for pathologic stage IB lung adenocarcinoma in high-risk patients as defined by a new recurrence risk scoring model. Cancer Res Treat 49(4):898–905
Jiang L et al (2015) The impact of visceral pleural invasion in node-negative non-small cell lung cancer: a systematic review and meta-analysis. Chest 148(4):903–911
Kang JH, Kim KD, Chung KY (2003) Prognostic value of visceral pleura invasion in non-small cell lung cancer. Eur J Cardiothorac Surg 23(6):865–869
Lakha S et al (2014) Prognostic significance of visceral pleural involvement in early-stage lung cancer. Chest 146(6):1619–1626
Maeda R et al (2011) Poor prognostic factors in patients with stage IB non-small cell lung cancer according to the seventh edition TNM classification. Chest 139(4):855–861
Nitadori JI et al (2013) Visceral pleural invasion does not affect recurrence or overall survival among patients with lung adenocarcinoma </= 2 cm: a proposal to reclassify T1 lung adenocarcinoma. Chest 144(5):1622–1631
Okamoto T et al (2018) A phase II randomized trial of adjuvant chemotherapy with S-1 versus S-1 plus cisplatin for completely resected pathological stage II/IIIA non-small cell lung cancer. Lung Cancer 124:255–259
Okuda K et al (2018) S-1 vs. paclitaxel plus carboplatin as adjuvant chemotherapy for completely resected stage II/IIIA non-small-cell lung cancer. Mol Clin Oncol 8(1):73–79
Oven Ustaalioglu BB et al (2013) Prognostic factors for lymph node negative stage I and IIA non-small cell lung cancer: multicenter experiences. Asian Pac J Cancer Prev 14(11):6287–6292
Park HS et al (2012) Overview of the surveillance, epidemiology, and end results database: evolution, data variables, and quality assurance. Curr Probl Cancer 36(4):183–190
Park BJ et al (2018a) Temporal and regional distribution of initial recurrence site in completely resected N1-stage II lung adenocarcinoma: the effect of postoperative adjuvant chemotherapy. Lung Cancer 117:7–13
Park HJ et al (2018b) Efficacy of adjuvant chemotherapy for completely resected stage IB non-small cell lung cancer: a retrospective study. J Thorac Dis 10(4):2279–2287
Qian J et al (2019) Adjuvant chemotherapy candidates in stage I lung adenocarcinomas following complete lobectomy. Ann Surg Oncol 26(8):2392–2400
Roselli M et al (2006) Postsurgical chemotherapy in stage IB nonsmall cell lung cancer: long-term survival in a randomized study. Int J Cancer 119(4):955–960
Salazar MC et al (2016) Adjuvant chemotherapy for T3 non-small cell lung cancer with additional tumor nodules in the same lobe. J Thorac Oncol 11(7):1090–1100
Seok Y, Jeong JY, Lee E (2017) Extent of visceral pleural invasion and the prognosis of surgically resected node-negative non-small cell lung cancer. Thorac Cancer 8(3):197–202
Shimizu K et al (2004) Visceral pleural invasion classification in non-small cell lung cancer: a proposal on the basis of outcome assessment. J Thorac Cardiovasc Surg 127(6):1574–1578
Shimizu K et al (2005) Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancer. J Thorac Cardiovasc Surg 130(1):160–165
Shin JW et al (2019) Prognostic factors in stage IIB non-small cell lung cancer according to the 8th edition of TNM staging system. Korean J Thorac Cardiovasc Surg 52(3):131–140
Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA Cancer J Clin 69(1):7–34
Stein CF et al (2010) Global burden of disease 2000: version 2, methods and results. Global program on evidence for health policy, 2010, Discussion Paper 50
Takizawa H et al (2018) Autofluorescence for the diagnosis of visceral pleural invasion in non-small-cell lung cancer. Eur J Cardiothorac Surg 53(5):987–992
Tanju S et al (2019) Level of pleural invasion effects on prognosis in lung cancer. Tumori 105(2):155–160
Taylor NA et al (2004) Equivalent outcome of patients with clinical Stage IIIA non-small-cell lung cancer treated with concurrent chemoradiation compared with induction chemotherapy followed by surgical resection. Int J Radiat Oncol Biol Phys 58(1):204–212
Thakur MK et al (2018) Risk of second lung cancer in patients with previously treated lung cancer: analysis of surveillance, epidemiology, and end results (SEER) data. J Thorac Oncol 13(1):46–53
Travis WD et al (2008) Visceral pleural invasion: pathologic criteria and use of elastic stains: proposal for the 7th edition of the TNM classification for lung cancer. J Thorac Oncol 3(12):1384–1390
Urushiyama H et al (2018) Oral fluorouracil vs vinorelbine plus cisplatin as adjuvant chemotherapy for stage II–III. A non-small cell lung cancer: propensity score-matched and instrumental variable analyses. Cancer Med 7(10):4863–4869
Wang WL, Shen-Tu Y, Wang ZQ (2011) Prognostic factors for survival of stage IB upper lobe non-small cell lung cancer patients: a retrospective study in Shanghai, China. Chin J Cancer Res 23(4):265–270
Yang X et al (2017) Prognostic value of visceral pleural invasion in non-small cell lung cancer: a propensity score matching study based on the SEER registry. J Surg Oncol 116(3):398–406
Yoshida J et al (2009) Visceral pleura invasion impact on non-small cell lung cancer patient survival: its implications for the forthcoming TNM staging based on a large-scale nation-wide database. J Thorac Oncol 4(8):959–963
Zhang H et al (2016) The predictive and prognostic values of factors associated with visceral pleural involvement in resected lung adenocarcinomas. Onco Targets Ther 9:2337–2348
Zhang T et al (2018) Meta-analysis of adjuvant chemotherapy versus surgery alone in T2aN0 stage IB non-small cell lung cancer. J Cancer Res Ther 14(1):139–144
Zou B et al (2010) A multicenter retrospective analysis of survival outcome following postoperative chemoradiotherapy in non-small-cell lung cancer patients with N2 nodal disease. Int J Radiat Oncol Biol Phys 77(2):321–328
This work was supported by a Grant from the International Science and Technology Cooperation Project of the Changzhou Science and Technology Bureau (number CZ20140016).
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Xie, J., Zhang, X., Hu, S. et al. Effects of adjuvant chemotherapy on survival of patients with stage IB non-small cell lung cancer with visceral pleural invasion. J Cancer Res Clin Oncol (2020). https://doi.org/10.1007/s00432-020-03276-w
- Visceral pleural invasion
- Adjuvant chemotherapy