Adjuvant treatment of stage IB lung cancer: Untangling the controversy

In summary, the current data do not support routine use of adjuvant chemotherapy for stage IB NSCLC. While no trials of platinum-based therapy have shown an overall survival advantage, a single study has demonstrated improved disease-free survival and overall survival in patients with tumors > 4 cm. If a benefit for stage IB disease does exist, it will probably be most evident in patients with larger tumors, most of which will be classified as stage IIA or IIB by the new staging system. Molecular-based risk assessment complements clinical staging, and in the future, a staging system based on tumor, nodes, metastases, and biology (TNMB) might refine our ability to predict prognosis and determine appropriate adjunctive therapies.