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

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Date
2015-02
Authors
Berry, Mark F
Coleman, Brooke K
Curtis, Lesley H
Worni, Mathias
D'Amico, Thomas A
Akushevich, Igor
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Abstract
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.
Type
Journal article
Subject
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung
Chemotherapy, Adjuvant
Female
Humans
Lung Neoplasms
Male
Neoplasm Staging
Pneumonectomy
Retrospective Studies
SEER Program
Survival Analysis
Permalink
https://hdl.handle.net/10161/14822
Published Version (Please cite this version)
10.1245/s10434-014-4056-0
Publication Info
Berry, Mark F; Coleman, Brooke K; Curtis, Lesley H; Worni, Mathias; D'Amico, Thomas A; & Akushevich, Igor (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). pp. 642-648. 10.1245/s10434-014-4056-0. Retrieved from https://hdl.handle.net/10161/14822.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Igor Akushevich

Research Professor in the Social Science Research Institute
Curtis

Lesley H. Curtis

Professor in Population Health Sciences
Lesley H. Curtis is Professor in the Departments of Population Health Sciences and Medicine in the Duke School of Medicine and was inaugural chair of the Department of Population Health Sciences.  A health services researcher by training, Dr. Curtis is an expert in the use of health care and Medicare claims data for health services and clinical outcomes research, and a leader in national data quality efforts. Dr. Curtis has led the linkage of Medicare claims with seve
D'Amico

Thomas Anthony D'Amico

Gary Hock Distinguished Professor of Surgery
Lung Cancer 1.Role of molecular markers in the prognosis and therapy of lung cancer 2.Genomic analysis lung cancer mutations Esophageal Cancer 1.Role of molecular markers in the prognosis and therapy of esophageal cancer 2.Genomic analysis esophageal cancer mutations

Mathias Worni

Medical Instructor in the Department of Surgery
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Alphabetical list of authors with Scholars@Duke profiles.
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