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A prospective observational study of postoperative adjuvant chemotherapy for non-small cell lung cancer in elderly patients (≥ 75 years)

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Abstract

Background

To examine the effects of postoperative adjuvant chemotherapy for elderly (≥ 75 years of age) patients with completely resected non-small cell lung cancer (NSCLC), we conducted a multi-institutional and prospective observational study.

Methods

Patients were recruited between January 2014 and December 2017, and assigned to two cohort groups based on the patients’ choice either to receive postoperative adjuvant chemotherapy (Cohort B) or not (Cohort A). All the patients were observed for 2 years after enrollment. The primary endpoint was the postoperative change of Karnofsky Performance Status (KPS) at 2 years. The secondary endpoints were postoperative recurrence-free survival (RFS) and overall survival (OS) at 2 years, and the completion rate of the adjuvant chemotherapy.

Results

Two hundred and seventy-two patients were enrolled (Cohort A, n = 225; Cohort B, n = 47). At any time point after surgery, no marked difference of KPS was observed between Cohort B and Cohort A. The RFS at 2 years was 70.8% (95% confidence interval [CI], 64.3–76.4) in Cohort A and 76.0% (95% CI 60.8–85.9) in Cohort B. The OS at 2 years was 85.9% (95% CI 80.4–89.9) in Cohort A and 89.1% (95% CI 75.8–95.3) in Cohort B. The completion rate of planned chemotherapy was 49.9% (95% CI 34.1–63.9%).

Conclusions

The elderly patients were not likely to choose to receive postoperative adjuvant chemotherapy; however, no significant adverse effect on postoperative KPS was identified.

Trial registration

Clinical Trial Registration ID: UMIN000020736.

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Funding

This study was funded by the Lung Oncology Group in Kyushu (LOGIK) (Fukuoka, Japan).

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Authors and Affiliations

  1. Department of General Thoracic Surgery, National Hospital Organization Beppu Medical Center, 1473 Uchikamado, Beppu, 874-0011, Japan

    Tokujiro Yano & Seiichi Fukuyama

  2. Department of Thoracic Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan

    Motoharu Hamatake

  3. Medical Information Center, Kyushu University Hospital, Fukuoka, Japan

    Shoji Tokunaga

  4. Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan

    Tatsuro Okamoto

  5. Department of Thoracic Surgery and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

    Koji Yamazaki

  6. Department of Thoracic Surgery, Oita City Medical Association’s Almeida Hospital, Oita, Japan

    Takashi Miura

  7. Department of Surgical Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan

    Takeshi Nagayasu

  8. Department of Thoracic Surgery, Kagoshima University, Kagoshima, Japan

    Masami Sato

  9. Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, Yufu, Japan

    Kenji Sugio

Authors
  1. Tokujiro Yano
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  2. Motoharu Hamatake
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  3. Shoji Tokunaga
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  4. Tatsuro Okamoto
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  5. Koji Yamazaki
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  6. Takashi Miura
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  7. Takeshi Nagayasu
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  8. Masami Sato
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  9. Seiichi Fukuyama
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  10. Kenji Sugio
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Consortia

Lung Oncology Group in Kyushu (LOGIK)

Corresponding author

Correspondence to Tokujiro Yano.

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The authors declare no conflicts of interest in association with the present study.

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Yano, T., Hamatake, M., Tokunaga, S. et al. A prospective observational study of postoperative adjuvant chemotherapy for non-small cell lung cancer in elderly patients (≥ 75 years). Int J Clin Oncol 27, 882–888 (2022). https://doi.org/10.1007/s10147-022-02143-7

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  • DOI: https://doi.org/10.1007/s10147-022-02143-7

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