Benefit of adjuvant chemotherapy after resection of stage II (T1-2N1M0) non-small cell lung cancer in elderly patients.
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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.
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung
Published Version (Please cite this version)10.1245/s10434-014-4056-0
Publication InfoAkushevich, Igor; Berry, Mark Francis; Coleman, BK; Curtis, Lesley H; D'Amico, Thomas Anthony; & Worni, Mathias (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 http://hdl.handle.net/10161/14822.
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Associate Research Professor in the Social Science Research Institute
Professor in Population Health Sciences
Dr. Curtis is a health services researcher who oversees a portfolio of projects that use observational data to address questions related to clinical and comparative effectiveness, pharmacoepidemiology, health care delivery, and epidemiological trends across a broad array of clinical conditions and clinical care settings. An expert in the use of Medicare claims data for health services and clinical outcomes research, she has led the linkage of Medicare claims with several large clinical regist
Gary Hock 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
Medical Instructor in the Department of Surgery
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