Value Of Adjuvant Chemotherapy Research Articles

The value of adjuvant chemotherapy in patients after resection of pancreatic adenocarcinoma following preoperative FOLFIRINOX: an international multicenter study

The value of adjuvant chemotherapy in patients after resection of pancreatic adenocarcinoma following preoperative FOLFIRINOX: an international multicenter study

Evaluating the benefits of adjuvant chemotherapy in patients with pancreatic cancer undergoing radical pancreatectomy after neoadjuvant therapy-a systematic review and meta-analysis.

More and more patients with pancreatic cancer (PC) received neoadjuvant therapy (NAT) and then underwent radical pancreatectomy. However, the benefit of adjuvant chemotherapy (AC) for these patients is still controversial. This study is designed to determine the benefits of postoperative AC for patients with PC undergoing NAT and radical resection. We conducted a comprehensive search of the PubMed, Embase, Web of Science, and Cochrane Library databases, covering the period from their inception until 10 September 2023. Our analysis focused on the assessment of overall survival (OS) and recurrence-free survival (RFS) through meta-analysis. The fixed-effects model and the random-effects model were used to process the data. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were employed to determine the necessary of administering AC for patients with PC who have undergone NAT and radical resection. We retrieved 3,063 search results, of which 3,048 were excluded because of duplication or after applying our inclusion and exclusion criteria. A total of 15 studies with 21,113 patients (7,794 patients in the AC group and 13,319 in the non-AC group) were included, all of which reported OS, and three studies reported disease-free survival (DFS)/tumor-specific survival (CSS)/RFS. The final results showed that AC significantly improved OS and DFS/CSS/RFS in patients with PC who underwent pancreatectomy after NAT [OS: HR = 0.80, 95% CI (0.75∼0.86), P < 0.00001, I2 = 48%; DFS/CSS/RFS: HR = 0.53, 95% CI (0.41~0.69), P < 0.00001, I2 = 0%]. Furthermore, we performed subgroup analyses and demonstrated that AC provided a significant survival benefit for patients with PC after NAT and resection regardless of the tumor size [<2-cm subgroup: HR = 0.72, 95% CI (0.5∼0.94), P = 0.01; ≥2-cm subgroup: HR = 0.79, 95% CI (0.65∼0.96), P = 0.02] and the margin status [R0 subgroup: HR = 0.83, 95% CI (0.77∼0.88), P < 0.00001; R2 subgroup: HR = 0.75, 95% CI (0.61∼0.92), P = 0.007]. AC also benefited the patients with a stage N0 [HR = 0.79, 95% CI (0.74~0.84), P < 0.00001], N1 [HR = 0.78, 95% CI (0.72∼0.85), P < 0.00001], or poorly/undifferentiated tumor [HR = 0.76, 95% CI (0.66∼0.87), P < 0.0001] in survival but not in patients with a stage N2 [HR = 0.69, 95% CI (0.43∼1.09), P = 0.11] or well/moderately differentiated tumor [HR = 0.97, 95% CI (0.66∼1.42), P = 0.87]. Although AC showed survival benefit for patients with PC undergoing radical pancreatectomy after NAT, we still need to consider the lymph node stage and the degree of differentiation of the tumor when we gave AC to a patient. High-quality prospective randomized controlled studies are required to well disclose the value of AC in patients with PC undergoing radical pancreatectomy after NAT. https://www.crd.york.ac.uk/prospero/ PROSPERO, identifier CRD42023461365.

Adjuvant chemotherapy in nasopharyngeal carcinoma

The value of adjuvant chemotherapy after definitive radiotherapy in locoregionally advanced nasopharyngeal carcinoma has been debated since the landmark publication of the Intergroup-0099 trial. 1 Al-Sarraf M LeBlanc M Giri PG et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol. 1998; 16: 1310-1317 Crossref PubMed Google Scholar The differing views occur for two reasons: (1) early chemoradiotherapy trials in the 2000s investigated various platinum-based regimens of concurrent chemoradiotherapy alone or in combination with adjuvant chemotherapy, with both strategies showing survival benefits over radiotherapy alone; and (2) it was generally observed that platinum doublet adjuvant chemotherapy after concurrent chemoradiotherapy was poorly tolerated. 2 Chua MLK Wee JTS Hui EP Chan ATC Nasopharyngeal carcinoma. Lancet. 2016; 387: 1012-1024 Summary Full Text Full Text PDF PubMed Scopus (934) Google Scholar The resistance towards recommending adjuvant chemotherapy to patients in the clinic was compounded after a phase 3 trial in China showed that adjuvant cisplatin–fluorouracil chemotherapy did not significantly improve failure-free survival after concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma compared with concurrent chemoradiotherapy alone. 3 Chen L Hu CS Chen XZ et al. Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemoradiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 3 multicentre randomised controlled trial. Lancet Oncol. 2012; 13: 163-171 Summary Full Text Full Text PDF PubMed Scopus (432) Google Scholar Concurrent chemoradiotherapy followed by adjuvant cisplatin–gemcitabine versus cisplatin–fluorouracil chemotherapy for N2–3 nasopharyngeal carcinoma: a multicentre, open-label, randomised, controlled, phase 3 trialOur findings suggest that concurrent adjuvant cisplatin–gemcitabine could be used as an adjuvant therapy in the treatment of patients with N2–3 nasopharyngeal carcinoma, although long-term follow-up is required to confirm the optimal therapeutic ratio. Full-Text PDF

Is There a Role for Adjuvant Chemotherapy in Pathologic Node-Negative Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiation Therapy?

Neoadjuvant chemoradiation therapy (NCRT, 5-fluorouracil and radiation) followed by resection and adjuvant chemotherapy (AC) is one of the standard treatment paradigms for locally advanced rectal adenocarcinoma. However, the utility of AC in patients with pathologic lymph node (pLN)-negative disease is unclear. Our aim is to assess the value of AC stratified by pLN status. The US Rectal Cancer Consortium database (2007-2017) was retrospectively reviewed for patients with clinical stage II and III rectal adenocarcinoma who received neoadjuvant chemoradiation (NACR) and curative-intent resection. Those who received neoadjuvant systemic chemotherapy or underwent local resection were excluded. Patients were categorized by pLN status. Primary outcome was overall survival (OS). Of 213 patients, 70% had pLN-negative disease and 30% pLN-positive disease. Median age was 57 years, 65% were male, and median follow-up was 31 months. Among patients with pLN-negative disease, 74% received AC. Receipt of AC was not associated with improved 5-year OS (82% versus 74%, respectively; p = 0.16). This finding persisted on multivariable analysis. Of patients with pLN-positive disease, 83% received AC. Patients with pLN-positive disease demonstrated improved 5-year OS with receipt of AC (72% compared with 0% with no adjuvant chemotherapy, p = 0.04). After receiving neoadjuvant chemoradiation, adjuvant chemotherapy for patients with pLN-negative disease does not appear to be associated with improved survival. Further validation and prospective studies are needed to evaluate the utility of adjuvant chemotherapy in this setting.

Exploration of prognostic factors and the value of adjuvant chemotherapy in T1a,bN0M0 triple-negative breast cancer: a prospective cohort study based on the SEER database.

BackgroundThere are limited published studies on the prognostic predictors and the value of adjuvant chemotherapy (CT) in T1a,bN0M0 triple-negative breast cancer (TNBC) after local therapy. Therefore, the aim of the present study was to explore the prognostic predictors and the value of adjuvant CT in this population.MethodsWe identified T1a,bN0M0 TNBC cases registered in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. We analyzed associations between patient characteristics and overall survival (OS) and breast cancer-specific mortality (BCSM), and differences in OS and BCSM in a CT and no chemotherapy (no CT) cohort before and after propensity score matching.ResultsOf the 3,065 SEER patients, 1,534 (50.0%) received adjuvant CT. The median follow up was 57 months (interquartile range: 39–75 months). The 5-year OS and cumulative BCSM were 93.6% and 3.3%, respectively. Younger age was not associated with lower OS or higher BCSM in the total and no CT cohorts. Higher histologic grade was associated with lower OS in the no CT cohort, and T1b tumors were associated with higher BCSM in the total cohort. Multivariable analysis showed no association between adjuvant CT and OS or BCSM.ConclusionsPatients with T1a,bN0M0 TNBC had an excellent prognosis with or without adjuvant CT. For this population, higher histologic grade and larger tumor size were predictors of poor prognosis, although the effect of age was complex. Our data did not support using adjuvant CT in patients with T1a,bN0M0 TNBC.

Prognostic Value of Radiotherapy and Chemotherapy in Stage I-III Merkel Cell Carcinoma.

PurposeMerkel cell carcinoma (MCC) is a highly malignant cancer associated with dismal survival outcomes. Surgery is the cornerstone for the management of MCC, but the benefit of radiotherapy (RT) and chemotherapy (CT) is still controversial. We aimed to investigate the prognostic value of RT and CT in the management of stage I-III MCC patients using the Surveillance, Epidemiology, and End Results (SEER) database.MethodsPatients with a histopathological diagnosis of MCC between 2010 and 2016 were included. The primary endpoint of this study was overall survival (OS). The prognostic significance for OS was analyzed by Cox proportional hazard regression model.ResultsA total of 1,691 patients were identified in the SEER database. Over half of the patients had received RT (56.7%), and 9.8% of the patients were documented to have received CT. The median OS for the entire cohort was 66.0 months, and the 5-year OS rate was 53.8%. In the multivariate analysis, receiving RT was associated with significantly improved OS (P < 0.001), while receiving CT significantly negatively impacted OS (P = 0.010). In stage III patients who underwent treatment based on surgical resection, RT was still demonstrated to be a positive factor (P = 0.002), while CT had no significant association with OS in the univariate analysis (P = 0.295).ConclusionsThe current data in the SEER database are consistent with earlier studies supporting the benefit of adjuvant RT for stage I-III MCC patients, but caution should be taken regarding the routine use of CT. For stage III MCC patients, the value of adjuvant CT needs to be confirmed in future studies.

Prognostic Value of Inflammatory Biomarkers in Patients With Stage I Lung Adenocarcinoma Treated With Surgical Dissection.

ObjectiveInflammation plays a crucial role in tumorigenesis and progression. Our purpose was to investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR), systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII), and develop a nomogram to predict the cancer-specific survival (CSS) and disease-free survival (DFS) of stage I lung adenocarcinoma patients.Methods1431 patients undergoing surgical resection with pathologically confirmed stage I lung adenocarcinoma were reviewed. The optimal cut-off values for NLR, SII, and SIRI were defined by the receiver operating characteristic (ROC) curve. Cox proportional hazards regression analyses were performed to recognize factors significantly correlated with CSS and DFS to construct the nomogram. The value of adjuvant chemotherapy on model-defined high-risk and low-risk patients was further explored.ResultsThe cohort had a median follow-up time of 63 months. Multivariate analysis revealed that higher NLR (≥2.606), higher SIRI (≥0.705), higher SII (≥580.671), later T stage, histological pattern with solid or micropapillary components and radiologic features with solid nodules were significantly associated with worse CSS and DFS. The concordance index (C-index) of the nomogram established by all these factors was higher than that of the TNM staging system both in CSS (validation set 0.778 vs 0.652) and DFS (validation set 0.758 vs 0.695). Furthermore, the value of the established nomogram on risk stratification in stage I lung adenocarcinoma patients was validated.ConclusionsHigher NLR, SII and SIRI pretreatment were associated with worse survival outcomes. A practical nomogram based on these three inflammatory biomarkers may help clinicians to precisely stratify stage I lung adenocarcinoma patients into high- and low-risk and implement individualized treatment.

Evaluating the Clinical Utility of Routine Sentinel Lymph Node Biopsy and the Value of Adjuvant Chemotherapy in Elderly Patients Diagnosed With Oestrogen Receptor Positive, Clinically Node Negative Breast Cancer.

Background:Sentinel lymph node biopsy (SLNB) provides staging information and guides adjuvant therapy in early breast cancer (EBC). Routine SLNB in oncogeriatricians with low-risk EBC remains controversial.Aims:To evaluate axillary management in elderly patients diagnosed with oestrogen receptor positive (ER+), clinically lymph node negative (cLN−) EBC, and to assess whether SLNB affects further axillary management or adjuvant chemotherapy (ACTX) decision making.Methods:Female patients aged > 65 years, diagnosed with ER+, human epidermal growth factor receptor-2 negative (HER2−), and cLN− breast cancer (BC), who underwent surgery and SLNB were included. Clinicopathological predictors of ACTX and completion axillary lymph node dissection (CALND) were determined. Kaplan-Meier analyses assessed survival outcomes.Results:A total of 253 patients were included (median age: 72 years, range: 66-90), all underwent SLNB; 50 (19.8%) had lymphatic metastasis on SLNB (SLNB+). Of these, 19 proceeded to CALND (38.0%), 10 (52.6%) of whom had further axillary disease (ALND+). 20 of the 50 SLNB+ patients received ACTX (40.0%) as did 31 of the 203 SLNB− patients (15.2%) (P < .001). Oncotype DX (ODX) testing was utilized in 82 cases (32.8%). Younger age (P < .001), SLNB+ (P < .001) and ODX score (P = .003) were all associated with ACTX prescription. ODX > 25 (OR: 4.37, 95% CI: 1.38-13.80, P = .012) independently predicted receiving ACTX. Receiving ACTX and proceeding to CALND did not improve disease-free (P = .485 and P = .345) or overall survival (P = .981 and P = .646).Conclusions:Routine SNLB may not be necessary in elderly patients diagnosed with ER+, cLN− EBC. Future oncogeriatric practice is likely to see genomic testing guiding ACTX prescription in this group.

The role of chemotherapy in patients with T1bN0M0 triple-negative breast cancer: a real-world competing risk analysis.

The objective of the present study was to implement Kaplan-Meier analysis, competing risk analysis, and propensity score matching to evaluate whether the patients with T1bN0M0 triple-negative breast (TNBC) could benefit from adjuvant chemotherapy. A total of 1849 patients were identified in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. All eligible patients were divided into two cohorts, the chemotherapy (1155 patients) and the no-chemotherapy (694 patients) cohorts. Similar 5-year breast cancer-specific survival (BCSS) was observed in the chemotherapy and no-chemotherapy cohorts (96.1% vs. 96.0%, p=0.820). The results of the competing risk analysis showed a comparable 5-year breast cancer-specific death (BCSD) in both groups (chemotherapy 3.6% vs. no-chemotherapy 3.4%, p=0.778). Also, a higher 5-year other causes death (OCD) was observed in the no-chemotherapy cohort (0.7% vs. 5.4%, p<0.001). Multivariable competing risks regression models showed no association between chemotherapy and BCSS (HR, 1.21; 95%CI, 0.64-2.31; p=0.560). After 1:1 PSM, no significant difference was also observed for BCSD and OCD between two cohorts. The value of adjuvant chemotherapy in patients with T1bN0M0 TNBC is less than the present guidelines recommend, suggesting that de-escalated treatment could be a potentially beneficial strategy in appropriately selected patients.

The value of adjuvant chemotherapy in stage II/III colorectal signet ring cell carcinoma

This study aimed to assess the benefit of postoperative adjuvant chemotherapy in stage II–III colorectal signet ring cell carcinoma (SRCC). Qualified postoperative patients were extracted from Surveillance, Epidemiology, and End Results (SEER) database from 2004 until 2015. We collected 1675 patients in the research, and 936 patients were subjected to adjuvant chemotherapy group. The proportions of married status, male, rectal cancer, grade III/IV, AJCC stage III and radiotherapy were higher; While, the rates of white race, ≥ 65 years old and located in cecum–transverse colon were lower in patients of chemotherapy group compared to no chemotherapy group (all P < 0.05). K-M plots revealed significantly better OS of adjuvant chemotherapy group than no chemotherapy group (P < 0.001). Meanwhile, there was no significantly different in CSS between the two groups (P = 0.93). However, after adjusting for confounding factors by multivariable Cox regression analysis, receipt of postoperative chemotherapy was still associated with better CSS and OS (CSS: hazard ratio [HR] = 0.719, 95% CI 0.612–0.844, P < 0.001) ; (OS: HR = 0.618, 95% CI 0.537–0.713, P < 0.001). Patients with stage II/III colorectal SRCC could receive survival benefit from postoperative adjuvant chemotherapy.

Adjuvant Chemotherapy in Elderly Colorectal Cancer Patients.

The value of adjuvant chemotherapy in elderly patients has been the subject of many overviews, with opinions varying from “not effective”, since randomized trials have not been performed, to “as effective as in young individuals”, based upon many retrospective analyses of randomized trials that have included patients of all ages. In the absence of randomized trials performed specifically with elderly patients, retrospective analyses demonstrate that the influence on the time to tumour recurrence (TTR) may be the same as in young individuals, but that endpoints that include death for any reason, such as recurrence-free survival (RFS), disease-free survival (DFS), and overall survival (OS), are poorer in the elderly. This is particularly true if oxaliplatin has been part of the treatment. The need for adjuvant chemotherapy after colorectal cancer surgery in elderly patients is basically the same as that in younger patients. The reduction in recurrence risks may be similar, provided the chosen treatment is tolerated but survival gains are less. Adding oxaliplatin to a fluoropyrimidine is probably not beneficial in individuals above a biological age of approximately 70 years. If an oxaliplatin combination is administered to elderly patients, three months of therapy is in all probability the most realistic goal.

Case Report on Leiomyosarcoma of the Vulva: A Rare Pathology

Leiomyosarcoma (LMS) of the vulva is rare. However it is the most common histologic subtype of vulvar sarcoma, accounting for approximately 1% of all vulvar malignancies. [1-8] Whether genetics and epigenetics play a role in pathogenesis is unclear. [1] The tumor is slow-growing with non-specific symptoms, has high metastatic potential, and follows a bimodal age distribution. [1-8] Diagnosis and prognosis are based upon immunohistochemical expression and criteria from early literature. [1,3,5-7] The most common therapeutic approach involves radical vulvectomy with lymph node resection. The value of adjuvant chemotherapy and radiation remains unknown. [1,3,5-8] Our case describes a 46-year-old Caucasian G2P2 female with LMS of the left labia.

Real-world evidence on adjuvant chemotherapy in older adults with stage II/III colon cancer.

Colon cancer represents one of the most common cancers diagnosed in older adults worldwide. The standard of care in resected stage II and stage III colon cancer continues to evolve. While there is unequivocal evidence to suggest both disease free and overall survival benefits with the use of combination chemotherapy in patients with stage III colon cancer, data regarding its use in patients with stage II colon cancer are less clear. Further, although colon cancer is a disease that affects older adults, there is considerable debate on the value of adjuvant chemotherapy in the aging population. In particular, many older patients are undertreated when compared to their younger counterparts. In this review, we will describe the clinical trials that contributed to the current adjuvant chemotherapy approach in colon cancer, discuss representation of older adults in trials and the specific challenges associated with the management of this sub-population, and highlight the role of comprehensive geriatric assessments. We will also review how real-world evidence complements the data gaps from clinical trials of early stage colon cancer.

Abstract 3144: Deep learning-based predictive biomarker for adjuvant chemotherapy in early-stage hormone receptor-positive breast cancer

Abstract Introduction: Predictive value of adjuvant chemotherapy for patients with early-stage hormone receptor-positive breast cancer has been suggested by 21-gene expression assay, although its cost-effectiveness has not been well-defined. We have developed the deep learning-based H&amp;E image analyzer named Lunit SCOPE, identifying and quantifying various histologic components from H&amp;E-stained whole slide images We hypothesized that cell proportions analyzed by Lunit SCOPE would be a potential prognostic and predictive biomarker of adjuvant chemotherapy in early-stage hormone receptor-positive breast cancer. Method: We have collected clinical data and H&amp;E slides from de-identified 2,915 early breast cancer patients in Samsung Medical Center, retrospectively. The 898 patients with hormone receptor-positive, T1b ~ T3 and N0 ~ N1mi have been selected to analyze the predictive value of adjuvant chemotherapy. Deep learning-based H&amp;E image analyzer, Lunit SCOPE, has been trained by 1,191 H&amp;E-stained whole slide images from another breast cancer patient cohort. In the whole slide image, biological and histological components such as cancer epithelium, cancer stroma, normal, fat, necrosis, lymphocyte, fibroblast, and other cells, have been annotated by over 10 pathologists. The outputs of Lunit SCOPE are the ratio of cancer epithelium, cancer stroma, normal, necrosis and fat in a whole slide image and intratumoral tumor infiltrating lymphocyte (TIL) and stromal TIL density. The recurrence score (RS) based on the output of Lunit SCOPE has been determined by using multivariate cox regression analysis for disease-free survival (DFS) in the patients without adjuvant chemotherapy. Result: Recurrence score (RS) was proportional to the cancer stroma ratio and stromal TIL density, but inversely proportional to intratumoral TIL density. When the RS cutoff was 0.913, 21.3% (191 out of 898) of patients were classified as high risk group (RS &amp;gt; cutoff). Among those without adjuvant chemotherapy, high risk group presented poor DFS (hazard ratio [HR] 4.23, 95% confidence interval [CI] 1.87-9.59, P = 1.73 x 10-4) and overall survival (OS, HR 4.95, 95% CI 1.39-17.6, P = 6.07 x 10-3) than the low risk group. Adjuvant chemotherapy did not prolong OS in patients with low risk group (HR 1.08, 95% CI 0.38-3.12, P = 0.885). However, interestingly, in those with high risk by Lunit SCOPE, adjuvant chemotherapy prolonged DFS (HR 0.35, 95% CI 0.15-0.86, P = 0.0161) and OS (HR 0.22, 95% CI 0.05-0.95, P = 0.0254), reflecting RS by Lunit SCOPE would be a significant predictive biomarker of adjuvant chemotherapy. Conclusion: Deep learning-based H&amp;E image analyzer, Lunit SCOPE, was possible to analyze the prognosis of breast cancer. Especially, only high risk patients of RS by Lunit SCOPE had survival benefit from adjuvant chemotherapy, which needs to be validated in clinical trials. Citation Format: Soo Youn Cho, Eun Yoon Cho, Kyunghyun Paeng, Geunyoung Jung, Sarah Lee, Sang Yong Song. Deep learning-based predictive biomarker for adjuvant chemotherapy in early-stage hormone receptor-positive breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3144.

Value of adjuvant chemotherapy using paclitaxel plus carboplatin after radical surgery with or without radiotherapy in stage IB-iia cervical adenocarcinoma with risk factors.

e17016 Background: The aim of this study was to evaluate the efficacy and safety of paclitaxel/carboplatin as an adjuvant systemic chemotherapy for stage IB-IIA cervical adenocarcinoma patients after radical hysterectomy and pelvic lymphadenectomy with or without radiotherapy(RT). Methods: The cases of all patients (n = 152) with FIGO IB-IIA cervical adenocarcinoma who were treated by radical hysterectomy and pelvic lymphadenectomy with or without RT at Chinese academy of medical sciences cancer institute and hospital between January 2008 and January 2017 were reviewed. Of these, 35 patients displayed high-risk prognostic factors (high-risk group), 65 displayed intermediate-risk prognostic factors meeting sedlis criteria(intermediate-risk group),and 54 cases presented poorly differentiated status or LVSI, without other risk factors. In the high-risk group,18 patients received adjuvant radiotherapy and concurrent cisplatin chemoradiotherapy(RT-CCRT ) and 17 received adjuvant radiotherapy plus systemic chemotherapy using Paclitaxel Plus Carboplatin (RT-CT ). In the intermediate-risk group, 47 patients were treated with RT-CCRT and 16 were treated with RT-CT ,among the patients with poorly differentiated status or LVSI ,20 were treated with adjuvant chemotherapy using Paclitaxel Plus Carboplatin (CT ) and 34 received no further treatment (NFT). Results: In the high-risk group, adjuvant RT-CT was significantly superior to RT-CCRT with regard to median PFS and 2-year PFS rate(93.07months vs 52,44months, 94.1% vs 72.2%), but the recurrence rate and survival rate showed no significantly difference(11.8% vs 33.3%,100% vs 83.3%) . In the intermediate-risk group, Patients receiving RT-CT showed a better 2-year PFS rate and recurrence rate compared to those with RT-CCRT (100% vs 90.7%, 6.3% vs 12.6%), but the differences were not statistically significant. Among the patients with poorly differentiated status or LVSI, addition of adjuvant systemic chemotherapy resulted in significantly improved 2-year PFS rate compared with the NFT group (95% vs. 75.2%,p = 0.032). Conclusions: Adjuvant systemic chemotherapy using Paclitaxel Plus Carboplatin improved the prognosis of FIGO stage IB-IIA cervical adenocarcinoma patients in the high-risk group and patients who presented 2 or more intermediate-risk factors. Early cervical adenocarcinoma patients with low differentiation or LVSI can also benefit from postoperative adjuvant TC chemotherapy.

Value of adjuvant chemotherapy in patients with resected stage IB solid predominant and solid non-predominant lung adenocarcinoma.

BackgroundThe use of adjuvant chemotherapy (ACT) for stage IB lung adenocarcinoma remains controversial. We examined the benefits of ACT in stage IB patients with tumors composed of solid material.MethodsThe records of 309 patients with stage IB lung adenocarcinoma who had undergone complete resection between 2006 and 2015 were reviewed. All pathological slides were evaluated for the composition of solid material.ResultsOur data showed that although disease‐free survival (DFS) and overall survival (OS) were not significantly different (P = 0.306 and P = 0.061, respectively) between patients displaying a solid pattern of tumor growth and treated with or without ACT, patients with a solid predominant pattern of tumor growth treated with ACT had longer DFS (hazard ratio 0.359; P = 0.033) and OS (hazard ratio 0.205; P = 0.003). In patients with solid non‐predominant patterns, treatment with ACT had no effect on DFS (P = 0.326) or OS (P = 0.508).ConclusionsPostoperative patients with the solid predominant pattern of stage IB lung adenocarcinoma may benefit from ACT, while those with the solid non‐predominant pattern will not.

P1.16-63 The Value of Adjuvant Chemotherapy in Patients with Resected Stage IB Solid Predominant and Solid Non-Predominant Lung Adenocarcinoma

P1.16-63 The Value of Adjuvant Chemotherapy in Patients with Resected Stage IB Solid Predominant and Solid Non-Predominant Lung Adenocarcinoma

Abstract MS2-3: Tailoring systemic therapy for patients with lobular breast cancer

Abstract Recent developments in breast cancer treatment include an increasing awareness of the role of systemic therapies in selected subgroups of patients. A consequence of this strategy is the importance of accurate and reliable histopathological assessment. Through the identification of lobular breast cancer, that account for up to 15% of all invasive breast carcinomas, it is possible to select patients with correlates of responsiveness to therapy other than important indicators of outcome. It was in fact demonstrated that the response to neoadjuvant chemotherapy is significantly lower in lobular breast carcinomas, if compared with the ductal histotype. Also the value of adjuvant chemotherapy in lobular carcinomas was recently questioned, while the magnitude of the effect of adjuvant trastuzumab is similar in lobular and ductal breast cancer. The diagnosis of lobular breast cancer might be relevant also for the selection of endocrine agents in the adjuvant treatment. In particular the relative effectiveness of letrozole compared with tamoxifen was shown to be greater for patients diagnosed with lobular breast cancer. Nevertheless, the use of available information has been limited in tailoring therapy on patients with the lobular subtype, due to the relative rarity of the disease, the absence of prospective studies and the limited number and size of retrospective analysis. The development of effective therapies for these patients should not rely on information mainly contributed from small retrospective analyses. Prospective tailored research through international cooperation is key to make progress and reach consensus on how to treat individual patients with lobular breast carcinomas. Citation Format: Colleoni MA. Tailoring systemic therapy for patients with lobular breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr MS2-3.

Adjuvant chemotherapy provided survival benefit for stage T2N0 gastric cancer with high-risk factors

The value of adjuvant chemotherapy in T2N0 gastric cancer (GC) remains controversial. The aim of this retrospective study is to define a high-risk subgroup of pathological T2N0 GC patients and examine the impact of adjuvant chemotherapy on overall survival (OS). A total of 225 patients underwent R0 resection for T2N0 gastric adenocarcinoma between 2002 and 2012 and 51/225 (22.7%) of these received adjuvant chemotherapy. Multivariate Cox regression identified tumor location in the Upper1/3 of the stomach (peast one of the independent risk factor listed above, and we found that adjuvant chemotherapy significantly improved OS for this subgroup.

Survival and the value of adjuvant chemotherapy in esophageal squamous cell carcinoma patients with lymphatic metastasis

Objective: To investigate the prognosis and the value of adjuvant chemotherapy in esophageal squamous cell carcinoma (ESCC) patients with lymphatic metastasis. Methods: From Jan, 2008 to Dec, 2011, 329 patients with ESCC who underwent two-field radical resection(R0), had lymphatic metastasis and survived over three months were enrolled in this study. There were 246 males and 83 females. The median age was 61 years-old. Site of lesion was located at upper- in 23, middle- in 226 and lower-thoracic segment in 80 patients. There were 114 patients treated with surgery alone and 215 patients with adjuvant chemotherapy. Prognostic factors including adjuvant chemotherapy were assessed in ESCC patients with lymphatic metastasis. Results: In 329 ESCC patients with lymphatic metastasis, the 1-, 3-, 5-years overall survival (OS) rate and progress-free survival (PFS) rate were 74.5%, 31.7%, 24.5%, and 55.1%, 27.8%, 24.2%, respectively. Median OS and PFS were 22 and 15 months, respectively. Multivariate analysis showed that, site of lesion and disease stage were independent factors for OS and PFS (P<0.05). Adjuvant chemotherapy was also an independent prognostic factor for OS (P<0.05). Subgroup analysis showed that adjuvant chemotherapy could improve OS mainly in patients of males, ages≤60, tumor length <6 cm, well- or mediated differentiated squamous cell carcinoma, stage pT3, pN2 and ⅢB (P<0.05). Conclusions: ESCC patients with lymphatic metastasis had poor prognosis. Site of lesion and disease stage were important prognositic factors for survival. Adjuvant chemotherapy could improve survival in specific patients.