This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Roger Giudicelli Pascal Thomas Pierre Fuentes Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Barlési, F. Articles by Fuentes, P. Search for Related Content PubMed PubMed Citation Articles by Barlési, F. Articles by Fuentes, P. Related Collections Lung - cancer

Survival and postoperative complication in daily practice after neoadjuvant therapy in resectable stage IIIA-N2 non-small cell lung cancer

^a Department of Thoracic Oncology, Sainte Marguerite Hospital, University of Méditerranée, Faculty of Medicine, Assistance Publique - Hôpitaux de Marseille, Marseille, France
^b Department of Thoracic Surgery, Sainte Marguerite Hospital, University of Méditerranée, Faculty of Medicine, Assistance Publique - Hôpitaux de Marseille, Marseille, France
^c Department of Pathology, Sainte Marguerite Hospital, University of Méditerranée, Faculty of Medicine, Assistance Publique - Hôpitaux de Marseille, Marseille, France
^d Department of Medical Information, Timone Hospital, University of Méditerranée, Faculty of Medicine, Assistance Publique - Hôpitaux de Marseille, Marseille, France

^* Corresponding author. Service d'Oncologie Thoracique, Département des Maladies Respiratoires, Hôpital Sainte-Marguerite, 270 Bd Sainte-Marguerite, 13274 Marseille Cedex 09, France. Tel.: +33-491-74-47-36; fax: +33-491-74-55-24
Fabrice.Barlesi{at}mail.ap-hm.fr

Regarding persisting controversies about neoadjuvant treatment (NT), we studied the impact of neoadjuvant therapy in daily practice. Patients with stage IIIA-N2 non-small cell lung cancer (NSCLC) resected after NT were eligible. Data on preoperative treatments, surgical procedure, postoperative complications and survival were collected. Overall, 71 (60 men, median age of 60 years) patients met inclusion criteria. All patients received a two-drug platinum-based regimen (median of 2.5 cycles [2–4 cycles]) and 15 (21%) had an associated radiotherapy (20–40 Gy). Nine complete and 27 partial responses were achieved. Surgical procedure principally was a lobectomy (44%), a left (15.5%) or a right (27%) pneumonectomy. Operative mortality was 4.2% while 21 patients (29%) experienced postoperative complications. Median survival was 17 months (95% CI, 13–21 months) with 3- and 5-year survival rates of 24 and 13%, respectively. Five-year survival was worse if postoperative complication occurred (18 versus 0%, ). Multivariate analysis showed male gender (, 95% CI, 0.16–0.81, ) and postoperative positive lymph node (, 95% CI, 1.4–5.2, ) to influence survival. In conclusion, achievement of a clinical and pathological response after NT for stage IIIA-N2 NSCLC patients enables a better survival. More efficient but also less toxic regimens of chemotherapy should be developed regarding its impact on long-term survival.

Key Words: Non-small cell lung cancer; Neoadjuvant chemotherapy; Pathological response; N2; Surgery; Postoperative complication

This article has been cited by other articles:

				R. J. Cerfolio, L. Maniscalco, and A. S. Bryant The Treatment of Patients with Stage IIIA Non-Small Cell Lung Cancer From N2 Disease: Who Returns to the Surgical Arena and Who Survives Ann. Thorac. Surg., September 1, 2008; 86(3): 912 - 920. [Abstract] [Full Text] [PDF]

				F. Barlesi, C. Doddoli, J.-P. Torre, R. Giudicelli, P. Fuentes, P. Thomas, and P. Astoul Comparative prognostic features of stage IIIAN2 and IIIB non-small-cell lung cancer patients treated with surgery after induction therapy Eur. J. Cardiothorac. Surg., October 1, 2005; 28(4): 629 - 634. [Abstract] [Full Text] [PDF]