Wednesday, November 01, 2006

Follow-up to Abnormal CxR

This is my VIP patient who got to see us and Hem-Onc at the same time and had a Squam on a CT-guided Bx.
She then had a PET scan which lit up on the mass and on a small (<1 cm) ipsilateral hilar lymph node.
She underwent a med which showed only reactive adenopathy. She had a lobectomy 2 days ago with a T2 squam with negative margins and negative nodes.
At your institution, would you offer adjuvant chemo, xRt, both or neither at this point?

3 comments - CLICK HERE to read & add your own!:

Anonymous said...

Adjuvant chemo should be at least considerd for NSCLC of stage 1b or higher after curative resection.

Arenberg said...

5 years out, the data on the group of patients with IB in the IALT trial is no longer statistically significant. Consequently, since ASCO last year, many oncologists are witholding adjuvant chemo for patients in this group, taking into account tumor size, vascular invasion, and patient risks etc., It would be a stretch to say that adjuvant chemo forms the standard of care for resected IB NSCLC.

Anonymous said...

Was the sample size adequate to exclude clinically meaningful treatment effect? I would say this is still an open question because there is a good chance that that was a type 2 error. 5yr survival after resection of 1b NSCLC still less than what I hope.