Adjuvant chemotherapy on survival of patients with stage IB non‑small cell lung cancer: a comparison study with propensity score matching

Abstract

BackgroundThis study aimed to investigate whether patients with stage IB NSCLC could benefit from adjuvant chemotherapy.MethodsIn the years 2010 to 2015, 1,829 NSCLC patients with stage IB disease were chosen from the SEER database. To equalize the baseline characteristics between the surgery plus adjuvant chemotherapy group (intervention) and the surgery alone group (control), propensity score matching (PSM) was used. The log-rank test plotted Kaplan–Meier survival curves to compare the overall survival (OS) and disease-specific survival (DSS). Cox proportional hazard regression was used to perform univariate and multivariate analysis on overall survival.ResultsOne hundred ninety-seven patients in each group with a mean follow-up period of 65.4 months were enrolled after PSM. A significant benefit in overall survival ([intervention vs. control] HR = 0.72; 95% CI: 0.54 to 0.94; P = 0.026) was detected in the intervention group before PSM. And there were significantly improved OS (HR = 0.63; 95% CI: 0.42 to 0.92; P = 0.036) and DSS (HR = 0.73; 95% CI: 0.52 to 0.95; P = 0.044) for the patients with visceral pleural invasion (VPI) in the intervention group compared with the control group. After PSM, the patients with VPI in the intervention group had better overall survival (HR = 0.69; 95% CI: 0.40 to 0.98; P = 0.048) than those in the control group. The Cox proportional hazard regression analysis showed that VPI (HR = 1.29; 95% CI: 1.11 to 1.54; P < 0.001) was also an independent prognostic factor.ConclusionStage IB NSCLC with VPI could benefit from adjuvant chemotherapy after R0 resection.