Propensity-matched analysis of adjuvant chemotherapy for completely resected Stage IB non-small-cell lung cancer patients

Li, Xiao; Zhang, Chao; Sun, Zewen; Yang, Fan; Xiao, Rongxin; Sui, Xizhao; Jiang, Guanchao; Zhong, Wen‐Zhao; Wang, Jun

doi:10.1016/j.lungcan.2019.04.024

Cited by 20 publications

(24 citation statements)

References 30 publications

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“…For patients with completely resectable NSCLC, adjuvant chemotherapy has been shown to improve survival [28]. However, NSCLC patients with the same TNM stage who underwent the same treatment regimen may have a different prognosis.…”

Section: Discussionmentioning

confidence: 99%

Preoperative systemic immune-inflammation index predicts prognosis and guides clinical treatment in patients with non-small cell lung cancer

Xue

2020

Bioscience Reports

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Objectives: The purpose of the present study was to evaluate the prognostic value of a systemic immune-inflammation index (SII) and the relationship between SII and the effectiveness of postoperative treatment in patients with non-small cell lung cancer (NSCLC). Methods: A total of 538 patients diagnosed with NSCLC who had undergone curative surgery were retrospectively enrolled in the study. Clinicopathologic and laboratory variables were collected. SII was defined as neutrophil × platelet/lymphocyte counts. Both univariate and multivariate analyses were performed to analyze the prognostic value of these factors. Results: The preoperative SII level was associated with sex, smoking history, histological type, lesion type, resection type, pathological stage, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), fibrinogen and bone metastasis (P<0.05). The univariate and multivariate analyses revealed that SII was an independent prognostic factor for disease-free survival (DFS, P=0.033) and overall survival (OS, P=0.020). Furthermore, the prognostic value of SII was also verified regardless of the histological type and pathological stage. The subgroup analysis demonstrated that patients with a high SII may benefit from adjuvant therapy (P=0.024 for DFS and P=0.012 for OS). Conclusion: An increased preoperative SII may independently predict the poor DFS and OS in patients with resectable NSCLC. SII may help select NSCLC patients who might benefit from adjuvant chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Preoperative systemic immune-inflammation index predicts prognosis and guides clinical treatment in patients with non-small cell lung cancer

Xue

2020

Bioscience Reports

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“…Some research studies have suggested that patients with stage IB NSCLC could benefit from adjuvant therapy (16)(17)(18), while other studies have reported no effects of adjuvant chemotherapy on patients (9,11,12,(19)(20)(21). Studies that have shown the benefit of adjuvant chemotherapy in stage IB patients tend to recommend adjuvant therapy for patients with tumor size ≥4 cm (7,8,12,22,23). However, stage IB (7th AJCC) disease with a tumor diameter >4 cm has been classified as stage IIA (8th AJCC) (4,24).…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have confirmed that tumor size ≥4 cm and visceral pleural invasion can worsen the prognosis of lung cancer patients (10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Stratification of Patients With Stage IB NSCLC Based on the 8th Edition of the American Joint Committee on Cancer (AJCC) Staging Manual

Jiang

et al. 2020

Front. Oncol.

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Objective: To assess the postoperative prognosis of patients with stage IB non-small cell lung cancer (NSCLC), using a prognostic model (PM).Methods: Patients with stage IB of NSCLC from the two academic databases {the Surveillance, Epidemiology, and End Results [SEER-A, N = 1,746 (training cohort)], Sun Yat-sen University Cancer Center [SYSUCC, N = 247 (validation cohort)], and SEER-B (N = 1,745)} who had undergone lung surgery from 2001 to 2015 were enrolled. The primary clinical endpoint was cancer-specific survival (CSS). Covariate inclusion of prognostic indicators was carried out using a multivariable two-sided P < 0.05. We identified and integrated significant prognostic factors for survival in the training cohort to build a model that could be validated in the validation cohort. We used univariate analysis to evaluate the utilized ability of PM in the different races/ethnicities.Results: CSS discrimination in the PM was comparable in both the training and validation cohorts [C index = 0.66(SEER-A), 0.67(SYSUCC), and 0.61(SEER-B), respectively]. Discretization with a fixed PM cutoff of 291.5 determined from the training dataset yielded low-and high-risk subgroups with disparate CSS in the validation cohort (training cohort: hazard ratio [HR] 2.724, 95% confidence intervals [CI], 2.074-3.577; validation cohort: SEER-B HR 1.679, 95% CI, 1.310-2.151, SYSUCC HR 3.649, 95% CI 2.203-6.043, all P < 0.05). Our five-factor PM was able to predict CSS; 48-month CSS was 87% in the low-risk subgroup vs. 69% in the high-risk subgroup for the training cohort, while in the validation cohort, they were 80 vs. 73%(SEER-B) and 84 vs. 60% (SYSUCC), respectively. In addition, the results showed that PM with all unadjusted HR > 1 was a significant risk prognostic indictor in white men (P < 0.001), Chinese people (P < 0.001), and other races (P = 0.012). Conclusion:We established and validated a PM that may predict CSS for patients with IB NSCLC in different races/ethnicities, and thus, help clinicians screen subgroups with poor prognosis. In addition, further prospective studies and more cases from different regions are necessary to confirm our findings.

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“…A caliper width equal to 0.1 of the standard deviation was used as the logit of the propensity score. 22 Patient characteristics between the propensity scorematched groups were compared using Mann-Whitney U-test or chi-square test. Further details on the PSM methods can be found in the Supplementary Table S1.…”

Section: Discussionmentioning

confidence: 99%

<p>Predictive Value of Postoperative Peripheral CD4+ T Cells Percentage in Stage I–III Colorectal Cancer: A Retrospective Multicenter Cohort Study of 1028 Subjects</p>

Li¹,

Liang

et al. 2020

CMAR

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Association of postoperative peripheral CD4+ T cells percentage and recurrence in colorectal cancer (CRC) remains to be explored. Therefore, we aimed to investigate the association between the postoperative peripheral CD4+ T cells percentage and recurrence in CRC patients. Patients and Methods: Consecutive stage I-III CRC patients without neoadjuvant treatment undergoing curative resection from January 2010 to July 2016 were identified in two Chinese centers. The association between the postoperative CD4+ T cells percentage, measured within 12 weeks after surgery, and recurrence-free survival (RFS) was analyzed. Results: A total of 1028 patients were identified (training set: 913 patients, validation set: 115 patients). In the training set, the 5-year RFS rate of the 441 patients with abnormal postoperative CD4+ T cells percentage was significantly lower than that of those with normal percentage (70.3% [95% CI 65.7-75.2%] vs 77.6% [95% CI 73.7-81.7%] and unadjusted hazard ratio [HR] 1.36 [95% CI 1.04-1.78], P=0.02). The result was confirmed in the validation set. Multivariable Cox regression analysis demonstrated that the association of postoperative CD4+ T cells percentage with 5-year RFS was independent both in the training and validation sets. In propensity score matching analysis, patients with normal postoperative CD4+ T cells percentage were found to have a favourable response to adjuvant chemotherapy (HR 0.29 [95% CI 0.12-0.72], P=0.008). Conclusion: Postoperative peripheral CD4+ T cells percentage is a predictive biomarker for RFS in patients with CRC, which can identify those who will benefit from adjuvant chemotherapy.

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Propensity-matched analysis of adjuvant chemotherapy for completely resected Stage IB non-small-cell lung cancer patients

Cited by 20 publications

References 30 publications

Preoperative systemic immune-inflammation index predicts prognosis and guides clinical treatment in patients with non-small cell lung cancer

Preoperative systemic immune-inflammation index predicts prognosis and guides clinical treatment in patients with non-small cell lung cancer

Stratification of Patients With Stage IB NSCLC Based on the 8th Edition of the American Joint Committee on Cancer (AJCC) Staging Manual

<p>Predictive Value of Postoperative Peripheral CD4+ T Cells Percentage in Stage I–III Colorectal Cancer: A Retrospective Multicenter Cohort Study of 1028 Subjects</p>

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