Chemotherapy beginning as long as four months after surgery may still improve outcomes in patients with non-small cell lung cancer (NSCLC), according to the results of a study published in JAMA Oncology.

Current evidence has shown that patients with NSCLC who have large tumors or metastasis to the lymph nodes can benefit from adjuvant chemotherapy treatment after surgery. However, the evidence to support the timing of that chemotherapy is lacking. Most clinicians recommend starting chemotherapy six to nine weeks after surgery, but in some cases, postoperative complications may affect patients’ ability to tolerate the treatment that soon.

Using data from the National Cancer Database, researchers evaluated 12,473 patients with stage I, II, or III NSCLC who received chemotherapy after surgery. They found that patients who started adjuvant chemotherapy 57–127 days after surgery had similar outcomes to patients who started the treatment the usual recommendation of 42–63 days after surgery.

The researchers cautioned that their findings only suggest a benefit of delayed chemotherapy but did not establish causality.

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