The use of adjuvant chemotherapy in early-stage non-small cell lung cancer (NSCLC) patients improved overall survival rates for patients in a recent study.

A group of investigators analyzed a large cohort of patients (29,908 patients) with pathologic stage T2N0M0 NSCLC and who underwent complete (R0) resection to evaluate the role of adjuvant chemotherapy in early-stage patients.

Patients were categorized into two cohorts: those who received adjuvant chemotherapy (5,209, 17.4%) and those who did not (24,699, 82.6%). The cohorts were further divided into four groups based on tumor size: 3-3.9 cm, 4-4.9 cm, 5-5.9 cm, and 6-7 cm.

The results, published in the Journal of Thoracic Oncology, demonstrated that adjuvant chemotherapy was associated with improved median overall survival (OS) and 5-year OS compared to the observation group in both univariate (one variable) and multivariate (multiple variables) analyses.

In the univariate analysis, the 5-year OS for patients not receiving adjuvant chemotherapy was inversely related to tumor size, decreasing from 58% in 3-3.9 cm to 46.9% in 6-7 cm. However, in patients that received adjuvant chemotherapy 5-year OS was nearly identical for 4-4.9 cm, 5-5.9 cm, and 6-7 cm groups.

Furthermore, all patients receiving adjuvant chemotherapy, regardless of tumor size, showed improved median OS (95.6 vs. 67.0 months, Hazard Ratio (HR) 0.64; 95% CI 0.61-0.68, P<0.0001) and 5-year OS (67.9% vs. 54.6%, P<0.0001) when compared to the observation group.

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