The effect of age on adjuvant chemotherapy with uracil-tegafur for completely resected stage I lung adenocarcinoma

ObjectiveTo evaluate overall survival (OS) and progression-free survival (PFS) after adjuvant therapy in stage I to stage IV uterine carcinosarcoma with rhabdomyosarcoma differentiation.MethodsMemorial Sloan-Kettering Cancer Center medical records from 1990 to 2012 were reviewed. Patients who received chemotherapy with or without radiation therapy (RT), or RT alone, for completely resected stage I to stage IV uterine carcinosarcoma with rhabdomyosarcoma differentiation were included.ResultsOf 53 patients, International Federation of Gynecology and Obstetrics stage distribution was as follows: I, 13 (24.5%); II, 8 (15.1%); III, 13 (24.5%); and IV, 19 (35.9%). Forty-one (77.4%) of 53 patients received adjuvant chemotherapy, and 34% of the patients who received chemotherapy also received pelvic RT or intravaginal brachytherapy (IVRT). Twelve (22.6%) of the 53 patients received only pelvic RT with/without IVRT. Paclitaxel-carboplatin was the most commonly used adjuvant chemotherapy treatment. The median PFS for the entire cohort was 13.4 months (95% confidence interval [CI], 10.5–17.0). The median OS for the entire cohort was 23.0 months (95% CI, 16.9–34.3). The median PFS periods by stage were 15.9 months for stages I/II versus 11.2 months for stages III/IV (P= 0.012). Median OS was not reached in the early-stage cohort. The median OS for the late-stage cohort was 20.9 months (P= 0.004). The median PFS periods by treatment were 10.4 months for pelvic RT with/without IVRT group versus 13.1 months for chemotherapy with/without pelvic RT with/without IVRT group (P= 0.498). The median OS periods by treatment were 23.6 months for chemotherapy with/without pelvic RT with/without IVRT group versus 16.9 months for pelvic RT with/without IVRT group (P= 0.501).ConclusionThe results suggest that chemotherapy alone or in combination with RT is associated with longer PFS and OS compared to RT alone. Only the stage of disease significantly affected PFS and OS.

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Driver mutation status in resected stage I lung adenocarcinoma: correlation with chest computed tomography findings

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2014.07.402 ◽

2014 ◽

Vol 219 (4) ◽

pp. e5

Author(s):

Michael Lanuti ◽

Haiyu Zhou ◽

Carol C. Wu ◽

Mari Mino-Kenudson ◽

Wen Chen ◽

...

Keyword(s):

Computed Tomography ◽

Lung Adenocarcinoma ◽

Stage I ◽

Driver Mutation ◽

Mutation Status ◽

Chest Computed Tomography ◽

Resected Stage

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Prognostic significance and adjuvant chemotherapy survival benefits of a solid or micropapillary pattern in patients with resected stage IB lung adenocarcinoma

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2017.09.143 ◽

2018 ◽

Vol 155 (3) ◽

pp. 1227-1235.e2 ◽

Cited By ~ 14

Author(s):

Fangfei Qian ◽

Wenjia Yang ◽

Rui Wang ◽

Jianlin Xu ◽

Shuyuan Wang ◽

...

Keyword(s):

Adjuvant Chemotherapy ◽

Lung Adenocarcinoma ◽

Prognostic Significance ◽

Stage Ib ◽

Resected Stage ◽

Micropapillary Pattern

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The influence of tumor size, histological differentiation and smoking history in patients with completely resected stage I adenocarcinoma of the lung

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.7197 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 7197-7197 ◽

Cited By ~ 1

Author(s):

M. Tsuboi ◽

H. Kato ◽

Y. Ichinose ◽

M. Ohta ◽

E. Hata ◽

...

Keyword(s):

Prognostic Factors ◽

Adjuvant Chemotherapy ◽

Adjuvant Treatment ◽

Tumor Size ◽

Stage I ◽

Smoking History ◽

Histological Differentiation ◽

Adenocarcinoma Of The Lung ◽

Well Differentiated ◽

Resected Stage

7197 Background: To test the hypothesis that patients with completely resected p-stage I adenocarcinoma [Ad.] of the lung contain a favorable subgroup of patients with well differentiated histology and tumor 2.0 cm or less in greatest dimension, we analyzed the results of the JLCRG trial (a randomized prospective trial of adjuvant chemotherapy with Uracil-Tegaful for stage I adenocarcinoma of the lung) by tumor size, smoking history, degree of histological differentiation and more. Methods: Patients were randomized to receive either oral uracil-tegaful (250 mg of tegaful /m2/day) for 2 years postoperatively or no adjuvant treatment. Multivariate analyses and interactions with the Cox proportional-hazards model were used to estimate the simultaneous effects of prognostic factors on survival. Results: The 5-year survival rate of the 412 patients with tumor 2cm or less in size was 89.8% (95% confidence interval [CI]: 86.8 to 92.8) versus 84.4% (95% CI: 81.3–87.4) for the 569 patients with tumor more than 2cm in size (median follow-up 72 months, p = 0.002). Although univariate analysis demonstrated improved survival for the patients with no smoking history and female gender, the selected covariates by multivariate analysis were as follows: age (hazard ratio [HR] for patients aged 70 years or more, 2.25; 95% CI: 1.58 to 3.14, p < 0.0001), tumor size (HR for more than 2cm in size, 1.55; 95% CI: 1.10 to 2.21, p = 0.012), histological differentiation (HR for moderate and poor differentiation, 1.75, 95% CI: 1.25 to 2.47, p = 0.001), and treatment group (HR for the uracil-tegaful group, 0.68; 95% CI: 0.49 to 0.94, p = 0.02). For these prognostic factors, there was only one significant interaction between tumor size and the adjuvant treatment. Conclusions: 1) Patients with completely resected stage I Ad. of the lung contain a favorable subgroup of patients with aged less than 70 years, well differentiated histology, and a maximum tumor dimension of 2.0 cm or less. 2) Adjuvant chemotherapy with oral uracil-tegaful should also be considered for stage I Ad. patients more than 2 cm in tumor size. 3) 2cm in tumor size might be a good benchmark candidate of the description of T factor to facilitate treatment strategies and revisions of the TNM staging system. No significant financial relationships to disclose.

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