Adjuvant chemotherapy for high-risk pathological stage I non
In patients with pathological stage I non-small cell lung cancer who have an increased risk of recurrence, adjuvant chemotherapy may be preventive.

This study aims to investigate the efficacy of adjuvant chemotherapy for pathological stage I non-small cell lung cancer (NSCLC) with a high risk for recurrence.

Prospectively collected data from 1,278 patients with pathological stage I NSCLC according to eighth edition staging guidelines undergoing lobectomy were retrospectively analyzed. Factors associated with a high risk for recurrence were determined. Survival was compared between patients who received adjuvant chemotherapy and those who did not.

- In multivariable analysis, age, invasive component size (>2 cm), visceral pleural invasion, lymphatic invasion, and vascular invasion were identified as independent factors for RFS.

- In patients with high-risk factors for recurrence such as pathological T1c/T2a or lymphovascular invasion, adjuvant chemotherapy resulted in significantly longer RFS and overall survival than in patients who did not receive adjuvant chemotherapy.

- In patients without any high-risk factors for recurrence, RFS was not significantly different between those who received adjuvant chemotherapy and those who did not.

Conclusively, adjuvant chemotherapy may improve survival in patients with pathological stage I NSCLC who have factors associated with high risk for recurrences, such as pathological T1c/T2a or lymphovascular invasion.

The Annals of Thoracic Surgery
Source: https://doi.org/10.1016/j.athoracsur.2021.04.108
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