Postoperative chemotherapy significantly improves survival of elderly patients with stage IB‐II non‐small cell lung cancer: A population‐based study

Background There is scant evidence‐based information about survival benefits of postoperative chemotherapy in elderly patients with early‐stage non‐small cell lung cancer (NSCLC). The purpose of this study is to compare the overall survival (OS) and cancer‐specific survival (CSS) rates of surgery al...

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Published in:Cancer medicine (Malden, MA) MA), 2023-05, Vol.12 (10), p.11254-11263
Main Authors: Liu, Wujianhong, Ma, Shangshang, Shi, Pingfan, Zhang, Yanfei, Li, Ming
Format: Article
Language:English
Subjects:
Aged
Cancer therapies
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Non-Small-Cell Lung - surgery
Chemotherapy
Chemotherapy, Adjuvant
elderly
Epidemiology
Humans
Lung cancer
Lung Neoplasms - drug therapy
Lung Neoplasms - surgery
Marital status
Medical prognosis
Neoplasm Staging
Non-small cell lung carcinoma
non‐small cell lung cancer
Patients
Population studies
Population-based studies
postoperative chemotherapy
Propensity Score
Small cell lung carcinoma
Small Cell Lung Carcinoma - pathology
stage I‐II
Surgery
survival analysis
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Summary:Background There is scant evidence‐based information about survival benefits of postoperative chemotherapy in elderly patients with early‐stage non‐small cell lung cancer (NSCLC). The purpose of this study is to compare the overall survival (OS) and cancer‐specific survival (CSS) rates of surgery alone versus postoperative chemotherapy in patients aged ≥70 years with stage I‐II NSCLC. Methods Elderly patients aged ≥70 years diagnosed with stage I‐II NSCLC were selected from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 2010 to December 31, 2015. OS and CSS were compared between the two groups utilizing overlap weighting analysis, inverse probability of treatment weight (IPTW), and propensity score matching (PSM). Results Of the 7193 included patients with stage I‐II NSCLC who are more than 70 years old, 681 patients (9.5%) received postoperative chemotherapy and 6512 patients (90.5%) received surgery‐alone. Median OS was 77 months in postoperative chemotherapy group versus 79 months in surgery‐alone group (p = 0.89). The result of IPTW analysis showed the similar results. The probability of patients choosing chemotherapy increased with the AJCC stage and Grade increasing (p 
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.5834