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Objectives Adjuvant chemotherapy (AC) in non-small cell lung cancer (NSCLC) has become a standard of care in patients with stages IIA, IIB, and IIIA after complete tumor resection. Utilization and outcome of AC in routine practice is described in a few studies, with non-conclusive results. Materials and methods This retrospective study included consecutive patients with NSCLC who underwent curative-intent surgery. Data of AC uptake in stages IB (tumor of ≥4 cm in diameter), II, and IIIA, and reasons of AC omission were evaluated according to medical records. Mortality risk among patients treated with surgery (only) and different types of AC in routine practice was compared. Results AC was applied to 79% of patients with stages IB (tumor of ≥4 cm in diameter), II, and IIIA, and was associated with an improved median of overall survival (HR = 0.69; 95% CI = 0.44-1.06). Significantly longer survival was achieved in the sub-group treated with platinum and oral vinorelbine (HR = 0.575, 95% CI = 0.339-0.974), and the longest survival was among patients treated with oral vinorelbine and cisplatin (HR = 0.371, 95% CI = 0.168-0.820). Conclusions AC utilization should be based on co-operation between surgeons, pneumo-oncologists, and patients. Rational use of AC offers better survival in routine practice.

Background: COPD is a heterogeneous condition with several clinical variants. The Czech Pneumological and Phthisiological Society defines 6 clinically relevant phenotypes: frequent exacerbator (FE), COPD-asthma overlap syndrome (ACOS), COPD-bronchiectasis overlap syndrome (BCOS), emphysematic phenotype (E), bronchitic phenotype (B), and pulmonary cachexia phenotype (CA). Methods: The Czech Multicentre Research Database of COPD (NCT01923051) is a multicentre, observational, and prospective study of consecutive patients with severe COPD (post-BT FEV1≤60%). The primary objective is to assess the all-cause mortality, as well as the assessment of prognostic COPD indexes, identication of clinical phenotypes, lung function and respiratory symptoms. Results: 647 severe COPD subjects were enrolled until Jan 2016. 637 of them were eligible for two-year analysis (67 ± 13yrs, post-BD FEV1 43.0±17.7%). On the whole, 388 (60.9%) were B, 254 (39.9%) were E, 193 (69.7%) were FE, 107 (16.8%) were BCOS, 94 (14.6%) were CA and 18 (2.8%) were ACOS subjects. 59 patients (16.1%) have died. We have found a significantly higher amount of deaths in the CA group (23, i.e. 30.7%, p Conclusion: Two clinical phenotypes, CA and FE, are associated with a significantly higher risk of death. ADO index and YCS appear to be suitable prognostic tools.