Postoperative chemotherapy significantly improves survival of elderly patients with stage IB‐II non‐small cell lung cancer: A population‐based study
Abstract Background There is scant evidence‐based information about survival benefits of postoperative chemotherapy in elderly patients with early‐stage non‐small cell lung cancer (NSCLC). The purpose of this study is to compare the overall survival (OS) and cancer‐specific survival (CSS) rates of s...
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| Format: | Article |
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Wiley
2023-05-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.5834 |
| _version_ | 1797810434842034176 |
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| author | Wujianhong Liu Shangshang Ma Pingfan Shi Yanfei Zhang Ming Li |
| author_facet | Wujianhong Liu Shangshang Ma Pingfan Shi Yanfei Zhang Ming Li |
| author_sort | Wujianhong Liu |
| collection | DOAJ |
| description | Abstract Background There is scant evidence‐based information about survival benefits of postoperative chemotherapy in elderly patients with early‐stage non‐small cell lung cancer (NSCLC). The purpose of this study is to compare the overall survival (OS) and cancer‐specific survival (CSS) rates of surgery alone versus postoperative chemotherapy in patients aged ≥70 years with stage I‐II NSCLC. Methods Elderly patients aged ≥70 years diagnosed with stage I‐II NSCLC were selected from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 2010 to December 31, 2015. OS and CSS were compared between the two groups utilizing overlap weighting analysis, inverse probability of treatment weight (IPTW), and propensity score matching (PSM). Results Of the 7193 included patients with stage I‐II NSCLC who are more than 70 years old, 681 patients (9.5%) received postoperative chemotherapy and 6512 patients (90.5%) received surgery‐alone. Median OS was 77 months in postoperative chemotherapy group versus 79 months in surgery‐alone group (p = 0.89). The result of IPTW analysis showed the similar results. The probability of patients choosing chemotherapy increased with the AJCC stage and Grade increasing (p < 0.001) and decreased with the growth of age (p < 0.001). The results of subgroup analysis showed that the survival rate of stage IA patients decreased significantly after postoperative chemotherapy (p < 0.01) while the survival rate of stage IB‐II patients increased significantly (p < 0.01). At the same time, we found that patients in the postoperative chemotherapy group tended to have better OS than those in the surgery‐alone group with the grade and tumor size increasing. Conclusion The results of this study indicated that postoperative chemotherapy could significantly improve the survival of stage IB‐II NSCLC patients aged ≥70 years, and decrease the survival of stage IA patients. |
| first_indexed | 2024-03-13T07:07:44Z |
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| id | doaj.art-88e407f95eab46cf965f2916954fd182 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-13T07:07:44Z |
| publishDate | 2023-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-88e407f95eab46cf965f2916954fd1822023-06-06T07:30:47ZengWileyCancer Medicine2045-76342023-05-011210112541126310.1002/cam4.5834Postoperative chemotherapy significantly improves survival of elderly patients with stage IB‐II non‐small cell lung cancer: A population‐based studyWujianhong Liu0Shangshang Ma1Pingfan Shi2Yanfei Zhang3Ming Li4Department of Respiratory Medicine, Shanghai Tenth People's Hospital Tongji University School of Medicine Shanghai 200072 ChinaDepartment of Respiratory Medicine, Shanghai Tenth People's Hospital Tongji University School of Medicine Shanghai 200072 ChinaDepartment of Respiratory Medicine, Shanghai Tenth People's Hospital Tongji University School of Medicine Shanghai 200072 ChinaDepartment of Respiratory Medicine, Shanghai Tenth People's Hospital Tongji University School of Medicine Shanghai 200072 ChinaDepartment of Respiratory Medicine, Shanghai Tenth People's Hospital Tongji University School of Medicine Shanghai 200072 ChinaAbstract Background There is scant evidence‐based information about survival benefits of postoperative chemotherapy in elderly patients with early‐stage non‐small cell lung cancer (NSCLC). The purpose of this study is to compare the overall survival (OS) and cancer‐specific survival (CSS) rates of surgery alone versus postoperative chemotherapy in patients aged ≥70 years with stage I‐II NSCLC. Methods Elderly patients aged ≥70 years diagnosed with stage I‐II NSCLC were selected from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 2010 to December 31, 2015. OS and CSS were compared between the two groups utilizing overlap weighting analysis, inverse probability of treatment weight (IPTW), and propensity score matching (PSM). Results Of the 7193 included patients with stage I‐II NSCLC who are more than 70 years old, 681 patients (9.5%) received postoperative chemotherapy and 6512 patients (90.5%) received surgery‐alone. Median OS was 77 months in postoperative chemotherapy group versus 79 months in surgery‐alone group (p = 0.89). The result of IPTW analysis showed the similar results. The probability of patients choosing chemotherapy increased with the AJCC stage and Grade increasing (p < 0.001) and decreased with the growth of age (p < 0.001). The results of subgroup analysis showed that the survival rate of stage IA patients decreased significantly after postoperative chemotherapy (p < 0.01) while the survival rate of stage IB‐II patients increased significantly (p < 0.01). At the same time, we found that patients in the postoperative chemotherapy group tended to have better OS than those in the surgery‐alone group with the grade and tumor size increasing. Conclusion The results of this study indicated that postoperative chemotherapy could significantly improve the survival of stage IB‐II NSCLC patients aged ≥70 years, and decrease the survival of stage IA patients.https://doi.org/10.1002/cam4.5834elderlynon‐small cell lung cancerpostoperative chemotherapystage I‐IIsurvival analysis |
| spellingShingle | Wujianhong Liu Shangshang Ma Pingfan Shi Yanfei Zhang Ming Li Postoperative chemotherapy significantly improves survival of elderly patients with stage IB‐II non‐small cell lung cancer: A population‐based study Cancer Medicine elderly non‐small cell lung cancer postoperative chemotherapy stage I‐II survival analysis |
| title | Postoperative chemotherapy significantly improves survival of elderly patients with stage IB‐II non‐small cell lung cancer: A population‐based study |
| title_full | Postoperative chemotherapy significantly improves survival of elderly patients with stage IB‐II non‐small cell lung cancer: A population‐based study |
| title_fullStr | Postoperative chemotherapy significantly improves survival of elderly patients with stage IB‐II non‐small cell lung cancer: A population‐based study |
| title_full_unstemmed | Postoperative chemotherapy significantly improves survival of elderly patients with stage IB‐II non‐small cell lung cancer: A population‐based study |
| title_short | Postoperative chemotherapy significantly improves survival of elderly patients with stage IB‐II non‐small cell lung cancer: A population‐based study |
| title_sort | postoperative chemotherapy significantly improves survival of elderly patients with stage ib ii non small cell lung cancer a population based study |
| topic | elderly non‐small cell lung cancer postoperative chemotherapy stage I‐II survival analysis |
| url | https://doi.org/10.1002/cam4.5834 |
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