Justin A. Drake, Jennifer L. Sullivan, Benny Weksler

Adjuvant chemotherapy prolongs survival in patients with non-small cell lung cancer with N1 disease or tumors larger than 4 cm. Patients with T3N0 disease due to chest wall invasion often receive adjuvant chemotherapy because their disease is classified as stage II non-small cell lung cancer. This study evaluated whether chemotherapy improves survival after complete resection of T3N0 non-small cell lung cancer with invasion of the chest wall. Patients who underwent complete resection of N0 non-small cell lung cancer with invasion of the chest wall were identified in the National Cancer Database. We performed propensity matching of patients who received adjuvant chemotherapy and patients who did not and examined survival. We identified 2326 eligible patients; 1050 patients (45%) received adjuvant chemotherapy, and 1276 patients (55%) did not. Patients who received chemotherapy after surgery had significantly better median survival than patients who did not (71 vs 39 months, P < .001). We identified 772 matched pairs. In the matched cohort, patients who received chemotherapy after surgery also had significantly better median survival (68 vs 39 months without chemotherapy, P < .001). In this large database study, adjuvant chemotherapy significantly improved survival in patients with T3 (chest wall) N0 non-small cell lung cancer after complete resection. Further studies are required to confirm our findings.