Neoadjuvant Treatment of Stage IIIA Non-Small Cell Lung Cancer Long-Term Results

Elias, Anthony; Skarin, Arthur T.; Gonin, René; Oliynyk, P; Stomper, Paul C.; O’Hara, Catherine; Socinski, Mark A.; Sheldon, Thomas A.; Maggs, Peter R.; Frei, Emil

doi:10.1097/00000421-199402000-00007

Cited by 36 publications

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“…30 Indeed, although many experiences have shown a poor prognosis in persistent N2 patients, 9 11 31 some authors have reported encouraging results in some subsets of these patients and provided evidence about the large variability of N2 disease. 32 33 34 35 In particular, Bueno et al 23 and Vansteenkiste et al 36 reported a 5YS rate of 9, 0, and 14%, respectively. In contrast, Cerfolio et al 37 reported a 5YS rate as 42% for a highly selected group of persistent N2 patients who underwent R0 resection after CT.…”

Section: Discussionmentioning

confidence: 99%

Survival Analysis of Surgically Resected ypN2 Lung Cancer after Neoadjuvant Therapy

İşgörücü

Çıtak

2022

Thorac Cardiovasc Surg

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Introduction Surgery is widely accepted today when downstaging of mediastinal lymph nodes after neoadjuvant therapy is achieved. However, the role of surgery in patients with persistent N2 disease is still controversial. This study aims to detail the diagnostic problems, prognostic features, and long-term survival of the persistent N2 non-small cell lung cancer patient group. Patients and Methods One-hundred fifty patients who received neoadjuvant therapy and subsequently underwent resection, in-between 2003 and 2015, were retrospectively analyzed. In this study, “persistent N2” group refers to patients who received neoadjuvant therapy for clinically or histologically proven N2, who underwent a surgery after having been classified as “downstaged” at restaging, but in whom ypN2 lesions were subsequently confirmed on the operative specimens. Patients with multistation N2 were included in the study. There were 119 patients who met the criteria, whereas persistent ypN2 was detected in 28.5% (n = 34) of all patients. Results Overall 5-year survival rate was 47.2%, while it was 23.4% for patients with persistent N2. Factors that adversely affected survival were to have nonsquamous cell histological type (p = 0.006), high ypT stage (p = 0.001), persistent N2 (p = 0.02), and recurrence during follow-up (p < 0.001). A trend toward a shorter survival was observed when the ypN2 zone was subcarinal versus other zones, but did not reach statistical significance (p = 0.08). In addition, a trend toward a shorter survival of patients with multiple N2 involvement (p = 0.412) was observed. Conclusion In the persistent N2 group, when multiple involvement or subcarinal involvement was excluded, relatively good survival was detected.

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Section: Discussionmentioning

confidence: 99%

Survival Analysis of Surgically Resected ypN2 Lung Cancer after Neoadjuvant Therapy

İşgörücü

Çıtak

2022

Thorac Cardiovasc Surg

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“…The next series of trials conducted during the 1980s tested first-generation cisplatin-based chemotherapy with or without sequential RT prior to surgery [13][14][15][16][17]. These small phase II trials enrolled a broad mix of stage subsets with variability in both disease bulk and the percentage of cases with biopsy proof of N2 disease.…”

Section: The First Induction Therapy Trialsmentioning

confidence: 99%

Induction chemotherapy or chemoradiotherapy before surgery for non-small-cell lung cancer

Albain

2000

Curr Oncol Rep

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Two controversies regarding the role of induction therapy before surgery in non-small-cell lung cancer are considered through a review of the literature and ongoing trials worldwide. The first debate asks whether surgery is indicated after induction chemotherapy or chemoradiotherapy for patients with advanced stage III disease. The second debate addresses disease presentations with early stage disease or radiographically negative but microscopically positive N2 involvement. The question raised for this group of patients is whether induction chemotherapy with or without radiotherapy should be routinely prescribed before the standard therapy of definitive surgery. For both controversies, data are provocative and in some subsets argue in favor of the more aggressive approach. However, changes in standard-of-care recommendations are premature. Thus, ongoing worldwide trials maintain control arms of chemoradiotherapy alone and of surgery alone in the advanced and early disease subsets, respectively.

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“…Die Frage nach einer möglichst optimalen Sequenz der onkologischen Verfahren und den effektivsten Zytostatika kann bisher nicht beantwortet werden. Auch die Bedeutung prognoserelevanter Faktoren wird nicht einheitlich beurteilt [3,6,10,23,24,27]. Die vorliegende Studie untersucht die Durchführbarkeit und Effektivität eines relativ aggressiven Therapieprotokolls mit Chemotherapie, simultaner Radiochemotherapie und nachfolgender Operation und analysiert die prognostische Bedeutung der pathohistologisch nachgewiesene Ansprechrate der mediastinalen Lymphknoten.…”

Section: Introductionunclassified

Remission mediastinaler Lymphknoten nach multimodaler Therapie des Bronchialkarzinoms - ein Prognosefaktor?

2003

Zentralbl Chir

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Neoadjuvant Treatment of Stage IIIA Non-Small Cell Lung Cancer Long-Term Results

Cited by 36 publications

References 0 publications

Survival Analysis of Surgically Resected ypN2 Lung Cancer after Neoadjuvant Therapy

Survival Analysis of Surgically Resected ypN2 Lung Cancer after Neoadjuvant Therapy

Induction chemotherapy or chemoradiotherapy before surgery for non-small-cell lung cancer

Remission mediastinaler Lymphknoten nach multimodaler Therapie des Bronchialkarzinoms - ein Prognosefaktor?

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