Better estimates of survival for patients considering adjuvant chemotherapy after surgery for early non-small-cell lung cancer.
BACKGROUND
The aim of this study was to summarise and describe survival data from contemporary randomised trials of platinum-based adjuvant chemotherapy for patients with non-small-cell lung cancer (NSCLC). The goal was to assist clinicians to provide better estimates of survival for patients considering adjuvant chemotherapy following surgical resection for NSCLC.


METHODS
Randomised trials of cisplatin-based adjuvant chemotherapy for resected NSCLC were identified. Survival rates at 1, 2, 5, 7 and 10 years and the following percentiles (scenario): 90th (worst case), 75th (lower typical), median, 25th (upper typical) and 10th (best case) were extracted from each overall survival (OS) curve.


RESULTS
Thirty-eight OS curves from 19 trials (7042 patients) were analysed. With adjuvant chemotherapy, the median OS rate (interquartile range) at 1 year was 91% (85-95), 2 years was 73% (69-88), 5 years was 61% (45-65) and 7 years was 49% (38-65). With observation only, the median OS rate (interquartile range) at 1 year was 88% (83-92), 2 years was 74% (65-82), 5 years was 55% (42-58) and 7 years was 40% (34-45). In both arms, survival rates at 2, 5 and 7 years were well estimated by raising the 1-year survival rate to the power of two, five and seven respectively. Few trials reported survival rates at 10 years.


CONCLUSIONS
Simple percentages and their powers provide a useful starting point for estimating and describing survival to patients considering adjuvant chemotherapy after surgery for NSCLC.
Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. georgiamccaughan@gmail.com
G J
GJ
McCaughan
P L
PL
Blinman
M J
MJ
Boyer
M R
MR
Stockler
D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D016032:Randomized Controlled Trials as Topic / Q000639:trends; D015996:Survival Rate / Q000639:trends*; D016896:Treatment Outcome