Surg Today. 2026 Jun 18. doi: 10.1007/s00595-026-03375-0. Online ahead of print.
ABSTRACT
PURPOSE: The current guidelines recommend cisplatin-based adjuvant chemotherapy for patients with completely resected stage II-III non-small cell lung cancer (NSCLC). Carboplatin-based chemotherapy is occasionally selected, although there is limited evidence of its long-term outcomes. We conducted this study to compare the long-term outcomes of cisplatin- based chemotherapy with those of carboplatin-based chemotherapy.
METHODS: A retrospective chart review was performed to identify patients aged ≥ 18 years with performance status 0-1, complete resection, and pathological stage II-IIIA NSCLC (7th edition) between 2014 and 2016 in our multi-institutional database. Patients were classified into two groups: the cisplatin-based adjuvant chemotherapy group and the carboplatin-based adjuvant chemotherapy group. To adjust for baseline differences, inverse probability of treatment weighting (IPTW) based on propensity scores was applied. The primary outcome was recurrence-free survival (RFS) and the secondary outcomes were cancer-specific survival (CSS) and overall survival (OS).
RESULTS: A total 342 patients were included, of whom 195 received cisplatin-based adjuvant chemotherapy and 147 received carboplatin-based chemotherapy. After IPTW adjustment, the hazard ratios for RFS, CSS, and OS were 1.10 (95% confidence interval [CI]: 0.82-1.49, p = 0.526), 1.11 (95% CI: 0.68-1.82, p = 0.675), and 1.46 (95% CI: 0.96-2.22, p = 0.08), respectively.
CONCLUSIONS: Carboplatin-based adjuvant chemotherapy may be considered for selected patients deemed unfit to receive cisplatin.
PMID:42313168 | DOI:10.1007/s00595-026-03375-0