• Vítězslav Kolek, Stanislav Losse, Juraj Kultan, Petr Jakubec, Zatloukal Jaromir, Milan Sova, Marek Szkorupa, Čestmír Neoral, Josef Škarda, Tomáš Tichý, and Zdeněk Kolář.
• a Department of Respiratory Medicine , University Hospital Olomouc , Olomouc , Czech Republic.
• Curr Med Res Opin. 2018 Sep 1; 34 (9): 1687-1694.

ObjectivesAdjuvant chemotherapy (AC) in non-small cell lung cancer (NSCLC) has become a standard of care in patients with stages IIA, IIB, and IIIA after complete tumor resection. Utilization and outcome of AC in routine practice is described in a few studies, with non-conclusive results.Materials And MethodsThis retrospective study included consecutive patients with NSCLC who underwent curative-intent surgery. Data of AC uptake in stages IB (tumor of ≥4 cm in diameter), II, and IIIA, and reasons of AC omission were evaluated according to medical records. Mortality risk among patients treated with surgery (only) and different types of AC in routine practice was compared.ResultsAC was applied to 79% of patients with stages IB (tumor of ≥4 cm in diameter), II, and IIIA, and was associated with an improved median of overall survival (HR = 0.69; 95% CI = 0.44-1.06). Significantly longer survival was achieved in the sub-group treated with platinum and oral vinorelbine (HR = 0.575, 95% CI = 0.339-0.974), and the longest survival was among patients treated with oral vinorelbine and cisplatin (HR = 0.371, 95% CI = 0.168-0.820).ConclusionsAC utilization should be based on co-operation between surgeons, pneumo-oncologists, and patients. Rational use of AC offers better survival in routine practice.

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