Annals of Thoracic Surgery Short Reports (Sep 2024)

Adjuvant Chemotherapy After Neoadjuvant Therapy and Surgery for Non-Small Cell Lung Cancer

  • Ryo Miyata, MD, PhD,
  • Masatsugu Hamaji, MD, PhD,
  • Akiyoshi Nakakura, MSc,
  • Hiroaki Ozasa, MD, PhD,
  • Masashi Kobayashi, MD, PhD,
  • Makoto Sonobe, MD, PhD,
  • Ryo Miyahara, MD, PhD,
  • Akihiro Aoyama, MD, PhD,
  • Ryutaro Kikuchi, MD, PhD,
  • Hiroshi Date, MD, PhD

Journal volume & issue
Vol. 2, no. 3
pp. 469 – 473

Abstract

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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.