ABSTRACT Background The survival benefits of adjuvant chemotherapy for stage IB non‐small cell lung cancer (NSCLC) remain controversial. The existing evidence is mostly based on the Caucasian population, especially the differences in efficacy among different races are not yet clear. Method Based on the data of patients with stage T2N0M0 NSCLC in the SEER database from 2010 to 2018 ( n = 7458), they were divided into white people (6076 cases) and non‐white people (1382 cases). The baseline characteristics of the adjuvant chemotherapy group and the non‐adjuvant chemotherapy group were balanced by propensity score matching (PSM). The overall survival (OS) was assessed using Kaplan–Meier methodology with log‐rank testing, while multivariable Cox regression analysis was employed to identify independent prognostic factors. Result Among white people, the OS of the adjuvant chemotherapy group was significantly better than that of the observation group ( p 4 cm), VPI, or grade of differentiation. There was no statistically significant difference in OS among non‐white people ( p > 0.05 before and after PSM), and only the poorly differentiated subgroup showed limited benefits ( p = 0.008). Multivariate Cox analysis confirmed that adjuvant chemotherapy was an independent predictor of OS in white people ( p < 0.001), but not associated with non‐white people ( p = 0.184). Conclusion There are significant racial differences in the efficacy of adjuvant chemotherapy for stage IB NSCLC, suggesting that treatment decisions need to be optimized in combination with racial background.
Xin et al. (Thu,) studied this question.
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