Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study

Abstract

The aim was to investigate the efficacy of neoadjuvant docetaxel -cisplatin and identify prognostic factors for outcome in locally advanced stage IIIA (pN2 by mediastinoscopy) non-small-cell lung cancer (NSCLC) patients. In all, 75 patients (from 90 enrolled) underwent tumour resection after three 3-week cycles of docetaxel 85 mg m À2 (day 1) plus cisplatin 40 or 50 mg m À2 (days 1 and 2). Therapy was well tolerated (overall grade 3 toxicity occurred in 48% patients; no grade 4 nonhaematological toxicity was reported), with no observed late toxicities. Median overall survival (OS) and event-free survival (EFS) times were 35 and 15 months, respectively, in the 75 patients who underwent surgery; corresponding figures for all 90 patients enrolled were 28 and 12 months. At 3 years after initiating trial therapy, 27 out of 75 patients (36%) were alive and tumour free. At 5-year follow-up, 60 and 65% of patients had local relapse and distant metastases, respectively. The most common sites of distant metastases were the lung (24%) and brain (17%). Factors associated with OS, EFS and risk of local relapse and distant metastases were complete tumour resection and chemotherapy activity (clinical response, pathologic response, mediastinal downstaging). Neoadjuvant docetaxel -cisplatin was effective and tolerable in stage IIIA pN2 NSCLC, with chemotherapy contributing significantly to outcomes.

Five‐year lung cancer survival

“…45 Disease-free survival was not reported. The most common sites of distant metastases were lung (24%) and brain (17%).…”

Pretreatment Serum Albumin Level is an Independent Prognostic Factor in Patients with Stage IIIB Non-Small Cell Lung Cancer: A Study of the Turkish Descriptive Oncological Researches Group

“…Non-small cell lung cancer (NSCLC) accounts for nearly 85% of all patients with lung cancer. About 80% of the patients have an advanced disease with a 5-year survival rate of 5 to 10% (Betticher et al, 2006;Siegel et al, 2014).…”

Is tumor location an independent prognostic factor in locally advanced non-small cell lung cancer treated with trimodality therapy?

“…To further improve the outcome of induction therapy, prognostic factors for this treatment setting needed to be identified. The histological response of resected specimens has been reported to be a prognostic factor for induction therapy followed by surgery (2,3).…”