WCLC 2025 - Posters & ePosters-P1.07.46 Adjuvant Systemic Therapy for Resected Stage IB-IIA NSCLC (AJCC 8Th Edition): A Real-World Cohort Study From SEER Database

P1.07.46 Adjuvant Systemic Therapy for Resected Stage IB-IIA NSCLC (AJCC 8Th Edition): A Real-World Cohort Study From SEER Database

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This retrospective cohort study analyzed data from the SEER database (2007–2021) to assess the effectiveness of adjuvant systemic therapy in surgically resected stage IB-IIA non-small cell lung cancer (NSCLC) patients, based on the AJCC 8th edition staging system. The study aimed to clarify the survival benefits of adjuvant chemotherapy, especially in patients with high-risk features, by examining both overall survival (OS) and lung cancer-specific survival (LCSS).<br /><br />Using multivariate Cox regression and competing risk models, supplemented by propensity score matching to reduce confounding bias, the study compared outcomes between patients who received adjuvant systemic therapy and those who underwent surgery alone. Results showed no survival benefit for stage IB patients, regardless of the presence of high-risk factors. In contrast, stage IIA patients experienced significantly improved OS (hazard ratio [HR] 0.75) and LCSS (subdistribution hazard ratio [SHR] 0.87) when treated with adjuvant therapy. The benefits were even more pronounced in stage IIA patients with high-risk features, with an OS HR of 0.69 and LCSS SHR of 0.76.<br /><br />The findings suggest that the survival benefit for stage IIA patients is primarily due to better cancer control rather than reduced mortality from non-cancer causes. Conversely, the lack of benefit—and potential harm—observed in stage IB patients argues against routine use of adjuvant chemotherapy in this group.<br /><br />The study recommends that future research should incorporate more detailed clinical data, including patient performance status, specifics of systemic therapy, and molecular testing results, to refine treatment decisions further.<br /><br />In summary, adjuvant systemic therapy provides a clear survival advantage in stage IIA NSCLC but not in stage IB, underscoring the need for tailored postoperative treatment strategies based on precise staging and risk profiling.

Asset Subtitle

Changtai Zhao

Meta Tag

Speaker Changtai Zhao

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

non-small cell lung cancer

NSCLC

adjuvant systemic therapy

stage IB

stage IIA

SEER database

overall survival

lung cancer-specific survival

high-risk features

propensity score matching