The Effects Of Postoperative Adjuvant Chemotherapy On The Prognosis Of Stage IB Non-small Cell Lung Cancer

Background and objective: At present,the choice of postoperative adjuvant chemotherapy for patients with stage IB non-small cell lung cancer(NSCLC)is still controversial.based on the eighth TNM staging of Union for International Cancer Control(UICC),this study explored the relevant clinicopathological factors for the prognosis of patients with stage IB NSCLC undergoing radical resection under the new stage,and the influence of postoperative adjuvant chemotherapy on the prognosis of stage IB NSCLC.Materials and methods:A retrospective analysis was performed on 119 patients with stage IB NSCLC in our hospital,and relevant follow-up data including clinicopathology,postoperative treatment and survival status were collected.All patients were followed up and analyzed.The survival rate was calculated by kaplan-meier method,and the difference in survival rate was compared by log-rank test.Cox proportional risk model was used to carry out multi-factor survival analysis,The effect of postoperative adjuvant chemotherapy on OS and DFS in patients with independent prognostic factors was analyzed by means of layered log-rank test.P < 0.05 was considered statistically significant.Results:1.As of July 31,2019,the end point of follow-up in this study,119 patients with stage IB NSCLC in the whole group were followed up for 7-138 months,among whom 33 died and 35 patients developed tumor recurrence and metastasis,The 1-year,3-year and 5-year survival rates were 98%,86% and 64%.2.In univariate analysis,The degree of tumor cell differentiation,visceral pleuralinvasion and vascular invasion are related to the prognosis of patients(P < 0.05).Gender,smoking history,pathological type,tumor location and adjuvant chemotherapy had no significant relationship with the prognosis of patients(p>0.05).3.In multivariate analysis,the degree of tumor cell differentiation(OS P=0.002;DFS P=0.003),vascular invasion(OS P=0.003;DFS P=0.008)and visceral pleural invasion(OS P=0.004;DFS P=0.007)were independent risk factors for the prognosis of stage IB NSCLC.4.In stratification analysis,There was statistically significant difference between OS and DFS in stage IB NSCLC patients with vascular invasion(OS P=0.007;DFS P=0.039)and tumor cells were poorly differentiated(OS P=0.016;DFS P = 0.020)with or without adjuvant chemotherapy,There was no significant difference between OS and DFS in stage IB NSCLC patients with no vascular invasion(OS P=0.34;DFS P=0.45)and tumor cells were well differentiated(OS P=0.317;DFS P = 0.393)with or without adjuvant chemotherapy,There was no significant difference between OS(P=0.521)and DFS(P=0.953)in stage IB NSCLC patients with visceral pleural invasion with or without adjuvant chemotherapy,There was no statistically significant difference between OS(P=0.145)and DFS(P= 0.063)in stage IB NSCLC patients with no invasion of visceral pleura with or without adjuvant chemotherapy.Conclusion:1.Postoperative adjuvant chemotherapy is not an independent prognostic factor for patients with stage IB NSCLC.2.Tumor cell differentiation,vascular invasion and visceral pleural invasion are independent risk factors affecting the prognosis of stage IB NSCLC.3.Adjuvant chemotherapy is recommended for patients with stage IB NSCLC with vascular invasion and poorly differentiated tumor cells,while patients with visceral pleural invasion may not benefit from adjuvant chemotherapy.