104P - Adjuvant chemotherapy may improve prognosis in surgically resected stage I NSCLC with lymphovascular invasion
- Shuyuan Wang (CN)
- Jianlin Xu (CN)
- Fangfei Qian (CN)
- Wenjia Yang (CN)
- Bo Zhang (CN)
- Jie Qian (CN)
- RONG Qiao (CN)
- Baohui Han (CN)
- Shuyuan Wang (CN)
Abstract
Background
The 8th edition of the TNM classification for non-small cell lung cancer (NSCLC) has recently been approved. Lymphovascular invasion (LVI) has been reported to be a strong risk factor for stage I patients. Meanwhile, the efficacy of adjuvant chemotherapy for surgically resected pathologic stage I NSCLC is controversial. This study aimed at exploring the association between adjuvant chemotherapy and survival in stage I NSCLC patients with LVI.
Methods
A total of 2600 patients with stage I NSCLC treated in the Shanghai Chest Hospital (2008–2012) were included in the analysis, of which 221 were pathologically diagnosed with LVI. We divided these patients into an ACT (adjuvant-chemotherapy) group and a surgery alone group. By using the Kaplan–Meier method and Cox proportional hazard regression model, we explored whether lymphovascular invasion was a poor prognostic factor and the application of adjuvant chemotherapy could improve the prognosis.
Results
For all stage I NSCLC patients, it was observed that patients with LVI had an unfavorable Lung-cancer specific survival (LCSS) (hazard ratio [HR]: 1.604; 95% confidence interval [CI]: 1.124–2.289; P = 0.009) and recurrence-free survival (RFS) (HR: 1.943; 95% CI: 1.491–2.532; P < 0.001). The presence of LVI was suspected to be correlated with larger tumor size, and adenocarcinoma. Analysis of 221 patients with LVI indicated an increased LCSS (HR: 0.31; 95% CI: 0.161–0.595; P < 0.001) and RFS (HR: 0.53; 95% CI: 0.530–0.286; P = 0.044) with adjuvant chemotherapy treatment. We saw significant differences in LCSS and RFS in patients treated with adjuvant chemotherapy with both stage IA and stage IB disease.
Conclusions
For all stage I NSCLC patients, LVI was correlated with poorer prognosis, which was improved by adjuvant chemotherapy. Our preliminary study suggests that adjuvant chemotherapy might be an appropriate option for stage I NSCLC patients with LVI.
Legal entity responsible for the study
Wang Shuyuan
Funding
Has not received any funding
Disclosure
All authors have declared no conflicts of interest.
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