Survival benefit of adjuvant chemotherapy after resection of Stage I lung adenocarcinoma containing micropapillary components

Abstract

Abstract Background The usefulness of postoperative adjuvant chemotherapy (ACT) for patients with stage I lung adenocarcinoma with micropapillary (MIP) components remains unclear. We analyzed whether postoperative ACT could reduce recurrence in patients with stage I lung adenocarcinoma with MIP components, thereby improving their overall survival (OS) and disease‐free survival (DFS). Methods Data for patients with pathologically confirmed stage I lung adenocarcinoma with MIP components from January 2012 to December 2018 were retrospectively analyzed. OS and DFS were analyzed in groups and subgroups. Results Overall, 259 patients were enrolled. Patients who received ACT in stage IA showed significantly better survival than did those with no‐adjuvant chemotherapy (NACT); (5‐year OS 89.4% vs. 73.6%, p < 0.001; 5‐year DFS 87.2% vs. 66.0%, p = 0.008). A difference was also observed for in‐stage IB patients (5‐year OS 82.0% vs. 51.8%, p = 0.001; 5‐year DFS 76.0% vs. 41.11 %, p = 0.004). In subgroup analysis based on the proportion of MIP components, patients with 1%–5% MIP components had a significantly better prognosis in the ACT group than in the NACT group (5‐year OS 82.4% vs. 66.0%, p = 0.005; 5‐year DFS 76.5% vs. 49.1%, p = 0.032). A similar difference was observed for patients with MIP ≥5% (5‐year OS 80.7% vs. 47.8%, p = 0.009; 5‐year DFS 73.11% vs. 43.5%, p = 0.007). Conclusion Among patients with stage I lung adenocarcinoma with MIP components, those who received ACT showed significant survival benefits compared to those without ACT. Patients with lung adenocarcinoma with MIP components could benefit from ACT when the MIP was ≥1%.

Keywords

• adjuvant chemotherapy
• lung adenocarcinoma
• micropapillary
• non‐small cell lung cancer
• radical resection of lung cancer