Preoperative Chemotherapy Plus Surgery Versus Surgery Plus Adjuvant Chemotherapy Versus Surgery Alone in Early-Stage Non–Small-Cell Lung Cancer

Felip, Enriqueta; Rosell, Rafael; Maestre, José; Rodríguez-Paniagua, José Manuel; Morán, Teresa; Astudillo, J.; Alonso, Guillermo; Borro, José Manuel; González-Larriba, José-Luis; Torres, Antonio; Camps, Carlos; Guijarro, Ricardo; Isla, Dolores; Aguiló, Rafael; Alberola, Vicente; Padilla, J.; Sánchez-Palencia, Abel; Sánchez, José Javier; Hermosilla, Eduardo; Massutí, Bartomeu

doi:10.1200/jco.2009.27.6204

Cited by 343 publications

(239 citation statements)

References 22 publications

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“…Moreover, implementation of adjuvant treatment does not significantly affect disease free survival (DFS) in earlystage LC patients (89). However, the benefits of neoadjuvant and/or adjuvant treatment in five-year survival after pneumonectomy for LC stage III patients are also reported in literature (40).…”

Section: Discussionmentioning

confidence: 99%

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Bablekos¹,

Analitis²,

Michaelides³

et al. 2016

Ann. Transl. Med.

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Background: Co-morbidity of primary lung cancer (LC) and heart disease (HD), both requiring surgical therapy, characterizes a high risk group of patients necessitating prompt diagnosis and treatment. The aim of this study is the review of available evidence guiding the management of these patients.Methods: Postoperative outcome of patients operated for primary LC (first meta-analysis) and for both primary LC and HD co-morbidity (second meta-analysis), were studied. Parameters examined in both meta-analyses were thirty-day postoperative mortality, postoperative complications, three-and five-year survival probabilities. The last 36 years were reviewed by using the PubMed data base. Thirty-seven studies were qualified for both meta-analyses. Results:The pooled 30-day mortality percentages (%) were 4.16% [95% confidence interval (CI): 2.68-5.95](first meta-analysis) and 5.26% (95% CI: 3.47-7.62) (second meta-analysis). Higher percentages of squamous histology and lobectomy, were significantly associated with increased (P=0.001) and decreased (P<0.001) thirty-day postoperative mortality, respectively (first meta-analysis). The pooled percentages for postoperative complications were 34.32% (95% CI: 24.59-44.75) (first meta-analysis) and 45.59% (95% CI: 35.62-55.74) (second metaanalysis). Higher percentages of squamous histology (P=0.001), lobectomy (P=0.002) and p-T1 or p-T2 (P=0.034) were associated with higher proportions of postoperative complications (second meta-analysis). The pooled threeand five-year survival probabilities were 68.25% (95% CI: 45.93-86.86) and 52.03% (95% CI: 34.71-69.11), respectively. Higher mean age (P=0.046) and percentage lobectomy (P=0.009) significantly reduced the five-year survival probability.Conclusions: Lobectomy and age were both accompanied by reduced five-year survival rate. Also, combined aorto-coronary bypass grafting (CABG) with lobectomy for squamous pT1 or pT2 LC displayed a higher risk of postoperative complications. Moreover, medical decision between combined or staged surgery is suggested to be individualized based on adequacy of coronary arterial perfusion, age, patient's preoperative performance status (taking into account possible co-morbidities per patient), tumor's staging and extent of lung resection.

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Section: Discussionmentioning

confidence: 99%

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Bablekos¹,

Analitis²,

Michaelides³

et al. 2016

Ann. Transl. Med.

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“…In the CALGB 9633 study, postoperative paclitaxel (PTX) plus CBDCA was found to be effective for tumors ≥4 cm in pathological stage IB [14]; however, in the NATCH study, it was not effective for early-stage lung cancer [15]. In the Four-Arm Study of platinum doublet for advanced-stage lung cancer, no significant differences were observed in the response rate or OS between PTX plus CBDCA and VNR plus CDDP [16].…”

Section: Discussionmentioning

confidence: 99%

Feasibility Study of Adjuvant Chemotherapy of S-1 and Carboplatin for Completely Resected Non-Small Cell Lung Cancer

Komazaki

Sakashita²,

Furuiye³

et al. 2013

Chemotherapy

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Background: The purpose of this study was to evaluate the feasibility and compliance of adjuvant chemotherapy of S-1 plus carboplatin for patients with completely resected non-small cell lung cancer (NSCLC) of pathological stage IB-IIIB. Methods: S-1 was given orally at a dose of 80 mg/m²/day for 2 weeks, followed by a 2-week period of no treatment. Carboplatin was given intravenously on day 8 at an area under the curve of 6. This regimen was repeated for four to six 28-day courses. Results: Seventeen patients were enrolled in this study. Fourteen of them completed at least 4 cycles of chemotherapy. Nine patients had grade 2 and three patients had grade 3 thrombocytopenia, respectively. Severe nonhematologic toxicities were uncommon. Treatment was delayed in a few patients because of prolonged thrombocytopenia. Conclusion: We concluded that the regimen was feasible and tolerable for patients with completely resected NSCLC as adjuvant chemotherapy.

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“…Randomized controlled trials in stage IA NSCLC did demonstrate that 5-year overall survival is similar when induction therapy followed by resection for cStage-IA was compared to resection followed by adjuvant chemotherapy for pStage-IA (2,3) .…”

Section: Rationale For Mediastinal Nodal Stagingmentioning

confidence: 99%

Cons: should a patient with stage IA non-small cell lung cancer undergo invasive mediastinal staging?

Decaluwé¹,

Dooms²

2016

Transl. Lung Cancer Res.

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Preoperative Chemotherapy Plus Surgery Versus Surgery Plus Adjuvant Chemotherapy Versus Surgery Alone in Early-Stage Non–Small-Cell Lung Cancer

Cited by 343 publications

References 22 publications

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

Feasibility Study of Adjuvant Chemotherapy of S-1 and Carboplatin for Completely Resected Non-Small Cell Lung Cancer

Cons: should a patient with stage IA non-small cell lung cancer undergo invasive mediastinal staging?

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