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    Adjuvant Chemotherapy Improves Survival in Surgically Resected Stage IB Squamous Lung Cancer
    Jianlin Xu, MD,* Shuyuan Wang, MD,* Hua Zhong, MD, Bo Zhang, MD, Jie Qian, MD, Wenjia Yang, MD, Fangfei Qian, MD, Rong Qiao, MD, Jiajun Teng, MD, Yuqing Lou, MD, Xueyan Zhang, MD, Tianqing Chu, MD, and Baohui Han, MD, PhD
    Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China  GENERAL THORACIC
    Background. At present there is a significant lack of clinical data for patients with surgically resected stage I squamous lung cancer. The purpose of this study was to investigate the impact of postoperative chemotherapy in this specific population.
    Methods. We retrospectively identified patients who had undergone complete squamous lung cancer resection at the Shanghai Chest Hospital between January 2008 and January 2014.
    Lung cancer is the most commonly diagnosed form of cancer and represents the leading cause of cancer-related death across the world. Non–small cell lung can-cer (NSCLC) constitutes approximately 85% to 90% of all lung cancers [1, 2]. In the last decade with the use of low-dose computed tomography (CT) for screening the pro-portion of patients detected with early-stage NSCLC has increased [3, 4]. The 5-year survival rate in patients with pathologic stage IA or stage IB NSCLC was 86.8% or
    Adjuvant chemotherapy (ACT) has been demonstrated to improve the outcomes of patients with N1/N2 NSCLC [6]. With regards to ACT for p-stage I NSCLC the current clinical data are controversial. The Japan Lung Cancer Research Group study, which used adjuvant tegafur-uracil for stage I lung adenocarcinoma, indicated a sig-nificant improvement in survival for all 979 patients with stage IA or IB disease (hazard ratio [HR], 0.71; 95% con-fidence interval [CI], 0.52–0.98) [7]. However, another
    *Drs Xu and Wang contributed equally to this work.
    Conclusions. The data presented herein demonstrated that ACT might provide survival benefits for squamous lung cancer patients with p-stage IB disease.
    Risk stratification may facilitate a personalized approach to the use of adjuvant therapy [9]. Current ev-idence suggests that ACT can be considered as a treat-ment for those with high-risk stage IB disease [10, 11]. The guideline of the American Society of Clinical Oncology suggested that the information of tumor size, histopath-ologic features, and genetic alterations should be included when consider making a recommendation of ACT for this specific population [6].
    Research has proven that smoking is related to both poorer recurrence-free survival (RFS) and worse overall survival (OS) for cases with pathologic T1N0M0 NSCLC [12]. According to previous reports squamous cell carci-noma (SCC) mostly develops in smokers, which may
    The Supplemental Tables and Figures can be viewed in the online version of this article [
    THORACIC  1684 XU ET AL Ann Thorac Surg
    GENERAL  partly explain the poorer survival rates of patients with SCC compared with those with adenocarcinoma [13–15]. The clinical evidence related to the use of ACT in stage I SCC is lacking.
    Material and Methods
    This study was approved by the Institutional Review Board of Shanghai Chest Hospital (Shanghai, China). Informed consent was waived because this was a retro-spective study.