Potential Benefit Of Adjuvant Chemotherapy Research Articles

Role of Adjuvant Chemotherapy in Early-Stage Combined Small Cell Lung Cancer

BackgroundThe role of adjuvant therapy in completely resected primary tumors that have components of both non–small cell lung cancer and small cell lung cancer (combined SCLC) is poorly understood. We sought to determine the potential benefits of adjuvant chemotherapy in patients who undergo complete resection for early-stage combined SCLC. MethodsOverall survival of patients with pathologic T1-2 N0 M0 combined SCLC who underwent complete resection in the National Cancer Database from 2004 to 2017, stratified by adjuvant chemotherapy vs surgery alone, was evaluated by multivariable Cox proportional hazards modeling and propensity score–matched analysis. Patients treated with induction therapy and those who died within 90 days of surgery were excluded from analysis. ResultsOf 630 patients who had pT1-2 N0 M0 combined SCLC during the study period, 297 patients (47%) underwent complete R0 resection. Adjuvant chemotherapy was administered to 63% of patients (n = 188), and 37% of patients underwent surgery alone (n = 109). In unadjusted analysis, the 5-year overall survival was 61.6% (95% CI, 50.8-70.7) for patients who underwent surgery alone and 66.4% (95% CI, 58.4-73.3) for patients who underwent adjuvant chemotherapy. In multivariable and propensity score–matched analysis, there were no significant differences in overall survival between adjuvant chemotherapy and surgery alone (adjusted hazard ratio, 1.16; 95% CI, 0.73-1.84). These findings were consistent when limited to patients who underwent lobectomies or to healthier patients who have at most 1 major comorbidity. ConclusionsIn this national analysis, patients with pT1-2 N0 M0 combined SCLC treated with surgical resection alone have similar outcomes to those who undergo adjuvant chemotherapy.

Impact of surgery and adjuvant chemotherapy on the survival of stage I lung adenocarcinoma patients with tumor spread through air spaces

ObjectivesTumor spread through air spaces (STAS) is a unique mechanism of lung cancer metastasis; however, its clinical value for stage I lung adenocarcinoma (ADC) remains unclear at present. We investigated the (1) prognosis of patients after sublobar resection compared with lobectomy for stage I lung adenocarcinoma with STAS; and (2) potential benefits of adjuvant chemotherapy (ACT) for patients with stage I ADC and STAS. MethodsA total of 3328 consecutive patients with stage I ADC were retrospectively identified between 2014 and 2018 at our institution; among them, 600 were diagnosed with STAS. Kaplan–Meier analysis and Cox proportional hazard regression models were used to evaluate the impact of STAS on overall survival (OS) and recurrence-free survival (RFS). ResultsAmong stage IA patients with STAS, there was no significant difference between those who underwent sublobar resection and lobectomy in OS (P = 0.919) and RFS (P = 0.066). Multivariate analysis confirmed this result (sublobar resection versus lobectomy, OS: HR = 0.523, 95 % CI, 0.056–18.458, P = 0.714; RFS, HR = 0.360, 95 % CI, 0.115–1.565, P = 0.897). ACT did not improve the prognosis of stage IA patients but did improve the RFS of stage IB patients with high-risk recurrence factors, including poorly differentiated tumors, lymphovascular invasion and visceral pleural invasion (P = 0.046). ConclusionsSublobar and lobectomy resection provided a comparable prognosis for stage IA ADC patients with STAS. When STAS was confirmed postoperatively, ACT should be considered for patients with stage IB with high-risk recurrence factors but not for those with stage IA disease.

4MO Prognostic implication of 21-gene expression assay in luminal B type hormone receptor-positive breast cancer patients younger than 40 years

Recurrence score (RS) based on 21-gene expression assay is widely used to evaluate prognosis and potential benefits of adjuvant chemotherapy (AC) for hormone-receptor positive (HR+) breast cancer (BC) patients (pts). In this study, we investigated clinical significance of RS in premenopausal HR+ BC pts.

Application of an artificial neural network for predicting the potential chemotherapy benefit of patients with gastric cancer after radical surgery

BackgroundArtificial neural network models have a strong self-learning ability and can deal with complex biological information, but there is no artificial neural network model for predicting the benefits of adjuvant chemotherapy in patients with gastric cancer. MethodsThe clinicopathological data of patients who underwent radical resection of gastric cancer from January 2010 to September 2014 were analyzed retrospectively. Patients who underwent surgery combined with adjuvant chemotherapy were randomly divided into a training cohort (70%) and a validation cohort (30%). An artificial neural network model (potential-CT-benefit-ANN) was established, and its ability to predict the potential benefit of chemotherapy was evaluated by the C-index. The prognostic prediction and stratification ability of potential-CT-benefit-ANN and the eighth American Joint Committee on Cancer staging system were compared by receiver operating characteristic curves and Kaplan-Meier curves. ResultsIn both the training and validation cohort, potential-CT-benefit-ANN shows good prediction accuracy for potential adjuvant chemotherapy benefit. The receiver operating characteristic curve showed that the prediction accuracy of potential-CT-benefit-ANN was better than that of the eighth American Joint Committee on Cancer staging system in all groups. The calibration plots showed that the predicted prognosis of potential-CT-benefit-ANN was highly consistent with the actual value. The survival curves showed that potential-CT-benefit-ANN could stratify prognosis well for all groups and performed significantly better than the eighth AJCC staging system. ConclusionThe potential-CT-benefit-ANN model developed in this study can accurately predict the potential benefits of adjuvant chemotherapy in patients with stage II/III gastric cancer. The benefit score based on potential-CT-benefit-ANN can predict the long-term prognosis of patients with adjuvant chemotherapy and has good prognostic stratification ability.

Short-term response might influence the treatment-related benefit of adjuvant chemotherapy after concurrent chemoradiotherapy for esophageal squamous cell carcinoma patients

BackgroundWhether adjuvant chemotherapy (AC) after concurrent chemoradiotherapy (CCRT) could provide benefit to esophageal squamous cell carcinoma (ESCC) patients is controversial. Therefore, we decided to investigate the potential benefit of AC after CCRT for ESCC and to identify biomarkers predictive of a clinical benefit.MethodsWe retrospectively analysed the clinical data of ESCC patients with clinical stage II–IVa who underwent CCRT. Then, we compared patients who received CCRT and AC (CCRT + AC group) with those who received CCRT alone (CCRT group). Propensity score analysis, subgroup analysis and an additional Cox regression model were conducted to analyse the predictive factors. The overall survival (OS) and progression-free survival (PFS) rates were taken as the endpoints.ResultsFrom January 2013 to December 2017, 244 patients were recruited (n = 131 for CCRT + AC; n = 113 for CCRT alone) for the analysis. After propensity score matching was performed (1:1 and 99 patients for each group) with consideration of the basic clinical characteristics, no significant differences were found in OS (HR = 1.024; 95% CI 0.737–1.423; P = 0.886) or PFS (HR = 0.809; 95% CI 0.582–1.126; P = 0.197) between the two groups. The good short-term response subgroup showed a better PFS and favoured CCRT + AC treatment (HR = 0.542; 95% CI 0.336–0.876; P = 0.008), the independent predictive role of which was confirmed in additional multivariate Cox regression analysis.ConclusionsAlthough AC did not significantly improve PFS and OS for all ESCC patients after CCRT, the short-term response to CCRT might help identify a subgroup that will benefit, which needs further prospective research to confirm.

Is adjuvant chemotherapy necessary for early gastric cancer?

Objective:To quantify the potential benefit of adjuvant chemotherapy (ACT) with respect to survival, and to identify factors for predicting prognoses in early gastric cancer patients.Methods:Patients with pT1 gastric cancer (GC) who underwent radical resection with D2 lymphadenectomy were retrospectively analyzed. Based on lymph node metastasis (LNM) status and treatment regimens, patients were classified into groups, and clinicopathological variables, overall survival (OS), and disease-specific survival (DSS) were compared.Results:Of 1,050 enrolled patients, 151 patients (14.4%) had a positive LNM status. Submucosal invasion, undifferentiated state, tumor size > 2 cm, ulceration, and lymphovascular invasion were independent risk factors for LNM using multivariate analyses. The 5-year OS of all patients was 96.4%. HER2 positive, perineural invasion, and LNM were independent factors for worse survival. Patients with pT1N3 GC had a worse 5-year OS and DSS than pT1N0, pT1N1, and pT1N2 patients (P < 0.001). The 5-year OS and DSS for pT1N1 patients showed no significant difference between ACT and surgery only patients. For pT1N2 patients, the 5-year OS and DSS showed no significant difference between S-1 and Xelox treatments. For pT1N3 patients, 7 (36.8%) received S-1, while 12 (63.2%) received Xelox treatment. Patients receiving Xelox treatment showed a better 5-year OS (75.0% vs. 14.3%) and DSS (81.8% vs. 20.0%) than patients receiving S-1 (P < 0.05).Conclusions:Curative surgery only was adequate for patients with pT1N0 and pT1N1. Xelox showed no survival benefits for pT1N2 patients. Therefore, S-1 is the optimal choice for pT1N2 patients, when considering adverse effects. Xelox is recommended for pT1N3 patients.

Residual lymph node disease and mortality following neoadjuvant chemoradiation and curative esophagectomy for distal esophageal adenocarcinoma

ObjectivesNeoadjuvant chemoradiation has been shown to improve survival in locally advanced esophageal and gastroesophageal junction cancer. The purpose of our study was to examine the effects of posttreatment persistent lymph node (LN) disease on overall survival (OS) and recurrence in patients with esophageal adenocarcinoma after neoadjuvant chemoradiation as well as the effect of LN harvest and the potential benefit of adjuvant chemotherapy. MethodsThe records of patients who underwent esophagectomy in our hospital from January 2005 until December 2016 were analyzed. Our study group consisted of 509 patients. ResultsPatient groups were created based on pathologic staging after esophagectomy (ypT N) as 22.0% of patients were ypT0 N0, 46.2% had incomplete response only at the primary tumor level (ypT + N0), and 31.8% had at least 1 metastatic lymph node (ypTx N+). Median OS was 58.3 months. The ypTx N+ group was divided into ypTx N1 and ypTx N2 or N3 subgroups based on the number of metastatic lymph nodes. The OS between the 2 groups was not significantly different (median OS, 37.6 vs 29.8 months; P = .097). The disease-free survival did show a statistically significant difference (median disease-free survival, 27.6 vs 13.7 months; P = .007). The LN harvest was not found to be significantly associated with OS. However, administration of adjuvant chemotherapy was a significant prognosticator for increased OS (hazard ratio, 0.590; P = .043). ConclusionsOur results demonstrate that residual LN disease after neoadjuvant chemoradiation is associated with increased mortality. Adjuvant chemotherapy, but not number of LNs resected, was correlated with increased OS in this subset of patients.

Biological behaviour of primary osteosarcoma of the digits, metacarpal and metatarsal bones in dogs.

Osteosarcoma (OSA) arising from the digits, metatarsal and metacarpal bones is rare and may carry a better prognosis compared with other locations. The aim of this study was to retrospectively evaluate the biological behaviour, the progression free interval (PFI), the survival time (ST) and evaluate the effect of adjuvant chemotherapy for OSA affecting these bones. Medical records from two academic institutions were reviewed and 15 cases were included. Descriptive statistics were used for signalment and history. For estimation of median PFI and median ST, the Kaplan-Meier method was utilized. The prognostic effect of chemotherapy, lymphocyte and monocyte count was investigated. Log-rank analysis was used to compare PFI and ST between groups. The overall median PFI and median ST were 377 and 687 days, respectively. No significant differences were noted for any of the variables evaluated. In this study, dogs affected by OSA of digits, metacarpal and metatarsal bones appear to have a longer ST compared with dogs with OSA of other appendicular locations. A study with a larger number of patients is needed to confirm these results and investigate the potential benefit of adjuvant chemotherapy.

Long term survival outcomes of stage I mucinous ovarian cancer - A clinical calculator predictive of chemotherapy benefit

ObjectivesTo determine the long-term potential benefit of adjuvant chemotherapy in subgroups of high-risk stage I mucinous ovarian cancer patients using a predictive scoring algorithm. MethodsData were collected from the National Cancer Database from 2004 to 2014. Based on demographic and surgical characteristics, a novel 10-year survival prognostic scoring system was developed using Cox regression. ResultsThere were 2041 eligible patients with stage I mucinous ovarian cancer including 1362 (67%) with stage IA/IB disease, 598 (29%) with stage IC disease, and 81 (4%) with stage I disease not otherwise specified. Median age was 52 with a range of 13–90 years old. 737 (36%) patients were treated with adjuvant chemotherapy. Adjuvant chemotherapy was more common in patients with stage IC relative to stage IA/IB disease (69% vs. 21%, P < 0.001) or with poorly-differentiated relative to well-differentiated tumors (69% vs. 23%, P < 0.001). Unadjusted 10-year survival was 81% relative to 79% for patients treated with vs. without chemotherapy, respectively (P = 0.46). Patients were predicted to exhibit a low- or a high-risk of death using a multivariate Cox regression model with age, stage, grade, lymphovascular space invasion and ascites. Risk of death without vs. with adjuvant chemotherapy was similar in low-risk patients (88% vs. 84%; HR = 0.80, 95%CI = 0.56–1.15, P = 0.23) and worse in high-risk patients (51% vs. 74%; HR = 1.58, 95%CI: 1.05–2.38, P = 0.03) with stage I mucinous ovarian cancer. ConclusionsA predictive scoring algorithm may provide prognostic information on long-term survival and identify high-risk stage I mucinous ovarian cancer patients who might achieve a survival benefit from adjuvant chemotherapy.

165 - A new promising risk stratifying tool based on combination of lymphovascular invasion and systemic immune-inflammation index to predict the survival and to help evaluate the potential benefit of adjuvant chemotherapy for upper tract urothelial carcinoma

165 - A new promising risk stratifying tool based on combination of lymphovascular invasion and systemic immune-inflammation index to predict the survival and to help evaluate the potential benefit of adjuvant chemotherapy for upper tract urothelial carcinoma

A Trial to Evaluate the Potential Benefit of Adjuvant Chemotherapy for Small Bowel Adenocarcinoma

A Trial to Evaluate the Potential Benefit of Adjuvant Chemotherapy for Small Bowel Adenocarcinoma

TAILORx Update

TAILORx Update

Making sense of adjuvant chemotherapy in colorectal cancer.

Surgical resection is the only curative treatment for locoregional colon cancer. The goal of adjuvant chemotherapy is to eradicate micro-metastatic disease and improve survival. This has been most clearly demonstrated in stage III (node-positive) disease, whereas benefit of adjuvant chemotherapy in stage II disease remains controversial. In stage III colon cancer, 6 months of adjuvant chemotherapy with oxaliplatin-based chemotherapy have been accepted as the standard for the last 15 years. The recent IDEA collaboration has challenged this in 2018; while overall was a negative non-inferiority study, pre-planned subset analyses do support that for patients with low-risk stage III disease, 3 months of XELOX (capecitabine and oxaliplatin combination) is non-inferior to 6 months. In stage II colon cancer, where the potential benefit of adjuvant chemotherapy is small, the emergence of biomarkers has helped in decision-making. Tumors with deficient mismatch repair protein (dMMR) do not benefit from 5-fluorouracil-based chemotherapy. For patients with high clinicopathological risk stage II disease with proficient mismatch repair proteins and good performance status, six months of adjuvant chemotherapy is still recommended. In the management of rectal cancers, where the risk of local recurrence is higher, chemoradiation (CRT) is often included as neoadjuvant or adjuvant therapy in the management of stage II and III rectal cancer. The benefit of adjuvant chemotherapy in rectal cancer has been extrapolated from adjuvant colon cancer studies with updated results from adjuvant rectal cancer studies demonstrating similar benefits. This review summarizes the current landscape of adjuvant therapy for patients with resected stage II and III colorectal cancer.

The potential benefit of adjuvant chemotherapy in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy is not predicted by tumor regression grade

Background: Recommended treatment for locally advanced rectal cancer (LARC) is neoadjuvant chemoradiotherapy (CRT) followed by surgery and total mesorectal excision (TME). The role of adjuvant chemotherapy (ACT) in this regimen is still debated. Assessment of Dworak’s tumor regression grade (TRG) after neoadjuvant CRT (NACRT) could potentially select patients who might benefit from adjuvant chemotherapy.

The benefit of adjuvant chemotherapy in the subtypes of ampullary adenocarcinoma: international propensity score matched study

Introduction: Ampullary adenocarcinoma (AAC) is a rare malignancy with extensive morphological heterogeneity. Randomized controlled trials regarding adjuvant chemotherapy in AAC are lacking. The aim of this study was to investigate the potential benefit of adjuvant chemotherapy in the suvtypes of AAC, using propensity score matching. Method: An international multicenter cohort study was conducted, including all patients who underwent pancreatoduodenectomy for AAC (January 2006 – December 2017). Propensity scores were used to match patients who received adjuvant chemotherapy to those who did not receive adjuvant chemotherapy, in the complete cohort and in two subgroups (pancreaticobiliary/mixed and intestinal subtype). Survival was assessed using the Kaplan-Meier method and Cox regressions. Result: Overall, 1163 patients underwent pancreatoduodenectomy for AAC. Of those, 179 patients were excluded for various reasons. Median survival of the resulting 976 patients was 67 (95% CI 56-78) months. A total of 520 patients received adjuvant chemotherapy and 456 patients did not. The most commonly given regimen was Gemcitabine monotherapy. In the matched cohort (194 vs 194 patients), median survival was not reached in the adjuvant chemotherapy group vs 60 months in the no adjuvant chemotherapy group, P=0.05. A survival benefit from adjuvant chemotherapy was seen in the pancreaticobiliary/mixed subtype; not reached median survival in patients receiving chemotherapy vs 32 months in those who did not, P=0.02. The intestinal subtype did not show a survival benefit from adjuvant chemotherapy (not reached vs not reached), P=0.72. Conclusion: Patients with the pancreaticobiliary/mixed subtype AAC showed a survival benefit from a Gemcitabine containing regimen. Intestinal subtype AAC showed no such survival benefit. It is unknown if and from what kind of adjuvant chemotherapy regimen, the latter group of patients benefit.

The prognostic value of a Surgical Outcome Risk Tool in patients after radical gastrectomy for gastric cancer and its guiding significance for postoperative chemotherapy

ObjectiveTo provide individualized survival predictors for patients after radical gastrectomy and to guide adjuvant treatment. MethodsThe data of patients with gastric cancer treated in our department from January 1996 to December 2014 were analyzed retrospectively. A Surgical Outcome Risk Tool (SORT) was used to indicate the physical condition of the patients. ResultsA total of 5327 patients in the study. The 5-year overall survival rates in the low-, moderate- and high-risk group were 61.6%, 54.7% and 44.4%, respectively (p < 0.001). A multivariate analysis showed that SORT was an independent prognostic factor for gastric cancer. There was significant chemotherapy benefit after surgery in stage II-III patients with a SORT<3 and in stage III patients with a SORT≥3 (p < 0.05). However, chemotherapy did not improve the 5-year overall survival in stage II patients with a SORT≥3 (62.4% vs. 48.3%, p = 0.196). The calculated difference between two nomogram models was the potential benefit of adjuvant chemotherapy for patients with gastric cancer. ConclusionA SORT is an independent risk factor for predicting the prognosis of gastric cancer, and postoperative adjuvant chemotherapy should be carefully adopted in stage II patients with a SORT≥3.

The potential benefit of adjuvant chemotherapy in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy is not predicted by tumor regression grade.

Recommended treatment for locally advanced rectal cancer (LARC) is neoadjuvant chemoradiotherapy (NACRT) followed by surgery and total mesorectal excision (TME). The role of adjuvant chemotherapy (ACT) in this regimen is still debated. Assessment of Dworak's tumor regression grade (TRG) after NACRT could potentially select patients who might benefit from ACT. Data for patients who underwent NACRT and TME for LARC between 2007 and 2014 were retrieved from the Bordet Institute database. Overall survival (OS) and disease-free survival (DFS) were calculated for the whole population, according to whether or not they received ACT, and according to TRG. We included 74 patients (38 males) with a median age of 62.7years (33-84years). AJCC stage cIIIb disease was the most frequent (73%). Pathologic complete response (pCR) was achieved in 13 patients (17.6%). ACT was administered to 42 patients (56.8%). Five-year OS and DFS of patients who received ACT or not were 92 and 84.5% (p = ns), and 79.9 and 84.8% (p = ns), respectively. OS was related to TRG (cut-off value of 3) (p = 0.001). ACT administration was not correlated with improved outcomes in any TRG groups. TRG is a prognostic factor for both OS and DFS but does not appear to have a significant benefit for the selection of patients with LARC treated with NACRT who might benefit from the administration of ACT. Prospective randomized trials with larger populations are needed to identify factors that predict which patients may benefit from the administration of ACT.

Clinical application and utility of genomic assays in early-stage breast cancer: key lessons learned to date.

Early-stage hormone receptor-positive breast cancer is the most common subtype and stage presenting in countries with organized screening programs. Standard clinical and pathologic factors are routinely used to support prognosis and decisions about adjuvant therapies. Hormone receptor and her2 status are essential for decision-making about the use of adjuvant hormonal and anti-her2 therapies respectively. Genomic assays are now commercially available to aid in either further prognostication or in refining the potential benefit of adjuvant chemotherapy. The current genomic assays all generally quantify estrogen receptor and proliferation gene sets (among others) by rna expression, although the specific genes assayed are quite discordant. The present review focuses on the pivotal studies in which each assay attempted to demonstrate clinical utility, with an emphasis on prospective trial data for each assay, if available. Using genomic assays, health care providers will increasingly be able to individualize therapy or de-escalate therapy, optimizing clinic benefit while minimizing toxicities from systemic therapies.

PD-L1 protein expression assessed by immunohistochemistry is neither prognostic nor predictive of benefit from adjuvant chemotherapy in resected non-small cell lung cancer

The expression of programmed death (PD) ligand 1 (PD-L1) protein expression assessed by immunohistochemistry (IHC) has been correlated with response and survival benefit from anti-PD-1/PD-L1 immune checkpoint inhibitor therapies in advanced non-small cell lung carcinoma (NSCLC). The efficacy of several agents appears correlated with PD-L1 expression. It remains controversial whether PD-L1 is prognostic in NSCLC. We assessed the prognostic value of PD-L1 IHC and its predictive role for adjuvant chemotherapy in early stage NSCLC. Tumor sections from three pivotal adjuvant chemotherapy trials (IALT, JBR.10, CALGB 9633) using the E1L3N antibody were studied in this pooled analysis. PD-L1 staining intensity and percentage in both tumor cells (TCs) and immune cells (ICs) were scored by two pathologists. The average or consensus PD-L1 expression levels across intensities and/or percent cells stained were correlated with clinicopathological and molecular features, patient survivals and potential benefit of adjuvant chemotherapy. Results from 982 patients were available for analysis. Considering staining at any intensities for overall PD-L1 expression, 314 (32.0%), 204 (20.8%) and 141 (14.3%) tumor samples were positive for PD-L1 staining on TCs using cut-offs at ≥1%, ≥10% and ≥25%, respectively. For PD-L1 expressing ICs, 380 (38.7%), 308 (31.4%) and 148 (15.1%) were positive at ≥ 1%, ≥10% and 25% cut-offs, respectively. Positive PD-L1 was correlated with squamous histology, intense lymphocytic infiltrate, and KRAS but not with TP53 mutation. EGFR mutated tumors showed statistically non-significant lower PD-L1 expression. PD-L1 expression was neither prognostic with these cut-offs nor other exploratory cut-offs, nor were predictive for survival benefit from adjuvant chemotherapy. PD-L1 IHC is not a prognostic factor in early stage NSCLC patients. It is also not predictive for adjuvant chemotherapy benefit in these patients.

Abstract P5-14-02: Triple negative breast cancer - Adjuvant chemotherapy use and survival outcomes in Stage IA disease

Abstract Background: The potential benefit of adjuvant chemotherapy in patients with Stage IA triple negative breast cancer (TNBC) has not been defined. In general, patients with T1a and T1b lesions have not been included in adjuvant chemotherapy trials and the inclusion of T1c tumors has been limited. In this study using National Cancer Data Base (NCDB) we investigated the actual use of adjuvant chemotherapy in Stage IA TNBC patients relative to tumor size (T1a, T1b, T1c) and report their survival outcomes. Patients and Methods: Using NCDB we evaluated a cohort of 13,065 women with TNBC diagnosed between 2010-2012 who had American Joint Committee on Cancer Stage IA (node-negative with pathological T1a, T1b or T1c) tumors. Overall survival (OS) was the primary outcome variable. Based on the tumor size, patients were stratified on receipt of adjuvant chemotherapy or not. Patients were also stratified according to receipt of adjuvant radiation, radiation with boost, or none. Other adjusted variables included: age, race, Charlson comorbidity index, payer status, income, education, distance traveled, treating facility, and treatment delays. Multivariate Cox regression was employed to analyze the effect of adjuvant chemotherapy on overall survival. Results: The mean patient age for the entire cohort was 59.2 years (range 22-90 years), 55.8 years for the chemotherapy group, and 67.8 years for the non-chemotherapy group. There were 1275 T1a, 3197 T1b, and 7729 T1c patients. Tumor size was a very strong predictor of survival. Compared to T1a tumors, HR for death was 1.43 (95% CI: 0.86 –2.37) for T1b tumors and 3.00 (95% CI: 1.86 – 4.83) for T1c tumors. Out of all T1a, T1b, and T1c tumors in this cohort, 48.1 %, 72.6%, and 89.3% of patients received adjuvant chemotherapy respectively. A hazard ratio (HR) of death was 0.42 (95% CI: 0.31 – 0.57) for all patients who received chemotherapy compared to non-chemotherapy group. 4-year OS by tumor size and chemotherapy usage is listed in the table indicating an absolute increase of OS with adjuvant chemotherapy employment. HR for death was 0.90 (CI: 0.62 – 1.31) with use of radiation only and 0.67 (95% CI: 0.53 – 0.85) with use of radiation with boost when compared to no radiation therapy. 4-year OS (in percentage) with and without adjuvant chemotherapy use for node-negative T1a, T1b, and T1c TNBCTumor sizeNo ChemotherapyChemotherapyP ValueT1a93.78 %98.36 %0.146T1b91.91 %97.10 %&amp;lt;0.0001T1c80.62 %94.41 %&amp;lt;0.0001 Conclusion: NCDB indicated that the majority of patients with Stage IA TNBC received adjuvant chemotherapy, including 48% of patients with T1a lesions. Our data analysis demonstrated a statistically significant 4-year OS benefit in patients with T1b and T1c tumors who received adjuvant chemotherapy compared to those who did not. The survival benefit of adjuvant chemotherapy in patients with T1a tumors, however, did not reach statistical significance. Prospective randomized trials could define the potential benefits of adjuvant chemotherapy in patients with Stage IA TNBC, particularly for those with T1a and T1b tumors. Citation Format: Patel AN, Shi R, Peddi P, Burton GV. Triple negative breast cancer - Adjuvant chemotherapy use and survival outcomes in Stage IA disease [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-14-02.