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Análisis de la supervivencia de la quimioterapia adyuvante postoperatoria para el cáncer de pulmón de células no

Shaowei Xin^1,2, Tao Wang², Xiaodi Qi¹

¹Department of Thoracic Surgery, 962 Hospital of the Joint Logistics Support Force, Harbin, Heilongjiang, China.

ANZ journal of surgery

|September 4, 2025

Resumen

La quimioterapia adyuvante mejora la supervivencia de los pacientes blancos con cáncer de pulmón de células no pequeñas (CPNPC) en estadio IB. Sin embargo, no muestra un beneficio significativo en la supervivencia de los pacientes no blancos, lo que indica la necesidad de estrategias de tratamiento específicas para cada raza.

Área de la Ciencia:

En el campo de la oncología
Investigación del cáncer
Ensayos clínicos y epidemiología

Sus antecedentes:

El papel de la quimioterapia adyuvante en la supervivencia del cáncer de pulmón de células no pequeñas (CPNP) en estadio IB sigue siendo objeto de debate.
Los datos existentes reflejan principalmente a las poblaciones caucásicas, lo que deja sin claridad las disparidades raciales en la eficacia del tratamiento.

Objetivo del estudio:

Investigar las diferencias raciales en la eficacia de la quimioterapia adyuvante para el NSCLC en estadio IB.
Para determinar si la quimioterapia adyuvante proporciona un beneficio de supervivencia en diferentes grupos raciales.

Principales métodos:

Análisis de 7458 pacientes con NSCLC en estadio T2N0M0 de la base de datos SEER (2010-2018).
Los pacientes se clasificaron en grupos blancos (6076) y no blancos (1382).
Propensity score matching (PSM) características basal equilibradas; supervivencia global (OS) evaluada a través de la regresión de Kaplan-Meier y Cox.

Principales resultados:

Los pacientes blancos que recibieron quimioterapia adyuvante mostraron una mejora significativa de la OS (p < 0,001) tanto antes como después de la PSM.
No se observaron diferencias significativas en la OS en pacientes no blancos (p > 0,05), excepto un beneficio limitado en el subgrupo poco diferenciado (p = 0,008).
El análisis multivariable de Cox identificó la quimioterapia adyuvante como un predictor independiente de la OS en pacientes blancos (p < 0,001) pero no en pacientes no blancos (p = 0,184).

Conclusiones:

Existen importantes disparidades raciales en la eficacia de la quimioterapia adyuvante para el NSCLC en estadio IB.
Las decisiones de tratamiento para el NSCLC en etapa IB deben tener en cuenta el origen racial del paciente para obtener resultados óptimos.
Se necesita más investigación para comprender los factores biológicos y clínicos que subyacen a estas diferencias raciales.

Palabras clave:

quimioterapia adyuvante Cáncer de pulmón de células no pequeñas heterogeneidad racial Análisis de la supervivencia

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