Adjuvant chemotherapy in stage IB NSCLC: implication of the new TNM staging system
Adjuvant chemotherapy (CT) became the standard of care for patients with completely resected non-small cell lung cancer. However, the evidence supports this intervention for stages II-IIIA only. For stage IB, the randomized trials were not able co configure a clear-cut conclusion. Positive results have been published by the Japanese investigators using uracil-tegafur, whereas no survival benefit was observed in the trials using platinum-based CT. The new TNM staging system adopted in 2009 operated some modifications which partially included the former stage IB. Despite the fact that the new staging system is currently in use, the recommendations regarding adjuvant CT, as they appear in the guidelines, are based on the evidence built on the previous TNM classification. Subsequently, the issue regarding adjuvant CT in stage IB deserves a new perspective. This paper will address the new viewpoint regarding adjuvant CT in stage IB, defined according to the current evidence and the amendments of new TNM staging system.