Abstract
Objectives: Survival benefits with preoperative chemotherapy for non-small cell lung cancer (NSCLC) remain controversial. Preoperative chemotherapy may act on micrometastasis but not lymph node metastasis. To clarify the role of induction chemotherapy for control of micrometastasis, we reviewed and compared 5-year follow-ups of clinical stage III but pathologically-proven node-negative NSCLC patients after complete resection with or without preoperative chemotherapy. Methods: We reviewed 148 consecutive patients who underwent anatomical lung resection and mediastinal nodal dissection for pathologically-proven node-negative NSCLC at our hospital between 1994 and 1999. Fifty-six patients were preoperatively diagnosed as stage III: 26 received platinum-based chemotherapy prior to surgery (PCT group) and 30 underwent surgery without any prior chemotherapy (PRS group). Results: The 5-year survival rate for clinical stage I/II and pathological node-negative patients was 74.9%; for clinical stage III, but for pathological node-negative patients it was 92.3% in the PCT and 63.3% in the PRS groups. The survival benefit of preoperative chemotherapy was significant for clinical stage III patients without node involvement. Conclusion: Preoperative chemotherapy may provide survival benefits for node-negative NSCLC patients.
Similar content being viewed by others
References
Roth JA, Fossella F, Komaki R, Ryan MB, Putnam JB Jr, Lee JS, et al. A randomized trial comparing perioperative chemotherapy and surgery with surgery alone in resectable stage IIIA non-small-cell lung cancer. J Natl Cancer Inst 1994; 86: 673–80.
Rosell R, Gomez-Codina J, Camps C, Maestre J, Padille J, Canto A, et al. A randomized trial comparing preoperative chemotherapy plus surgery with surgery alone in patients with non-small-cell lung cancer. N Engl J Med 1994; 330: 153–8.
Depierre A, Milleron B, Moro-Sibilot D, Chevret S, Quoix E, Lebeau B, et al, French Thoracic Cooperative Group. Preoperative chemotherapy followed by surgery compared with primary surgery in resectable stage I (except T1NO), II, and IIIa non-small-cell lung cancer. J Clin Oncol 2002; 20: 247–53.
Mountain CF. Revisions in the intermational system for staging lung cancer. Chest 1997; 111: 1710–7.
Martini N, Bains MS, Burt ME, Zakowski MF, McCormack P, Rusch VW, et al. Incidence of local recurrence and second primary tumors in resected stage I lung cancer. J Thorac Cardiovasc Surg 1995; 109: 120–9.
al-Kattan K, Sepsas E, Fountain SW, Townsend ER. Disease recurrence after resection of stage I lung cancer. Eur J Cardiothorac Surg 1997; 12: 380–4.
Hsu CP, Shai SE, Hsia JY, Chen CY. Clinical significance of bone marrow microinvolvement in nonsmall cell lung cancer. Cancer 2004; 100: 794–800.
de Boer RH, Smith IE, Pastorino U, O’Brien ME, Ramage F, Ashley S, et al. Pre-operative chemotherapy in early stage resectable non-small cell lung cancer: A randomized feasibility study justifying a multicenter phase III trail. Br J Cancer 1999; 79: 1514–8.
Pisters KM, Ginsberg RJ, Giroux DJ, Putnam JB, Jr, Kris MG, Johnson DH, et al. Induction chemotherapy before surgery for early-stage lung cancer: A novel approach. Bimodality Lung Oncology Team. J Thorac Cardiovasc Surg 2000; 119: 429–39.
Noguchi M, Morikawa A, Kawasaki M, Matsuno Y, Yamada T, Hirohashi S, et al. Small adenocarcinoma of the lung. Histologic characteristics and prognosis. Cancer 1995; 75: 2844–52.
Saito M, Miura T, Furukawa K, Kato H. Reevaluation of the surgical indications for lung cancer based on the N factor (Eng astr). Nippon Geka Gakkai Zasshi 2001; 102: 511–6.
Niizeki H, Morikawa T, Okushiba S, Kondo S, Katoh H. Survival and prognostic factors in resected cN2-pN0 non-small cell lung cancer. Ann Thorac Cardiovasc Surg 2004; 10: 9–13.
Goldie D, Coldman AJ. A mathematic model for relating the drug sensitivity of tumors to their spontaneous mutation. rate. Cancer Treat Rep 1979; 63: 1727–33.
Le Chevalier T, Arriagada R, Tarayre M, Lacombe-Terrier MJ, Laplanche A, Quoix E, et al. Significant effect of adjuvant chemotherapy on survival in locally advanced non-small-cell lung carcinoma. J Natl Cancer Inst 1992; 84: 58.
Roberts JR, Eustis C, Devore R, Carbone D, Choy H, Johnson D. Induction chemotherapy increases perioperative complications in patients undergoing resection for non-small cell lung cancer. Ann Thorac Surg 2001; 72: 885–8.
Albain KS, Rusch VW, Crowley JJ, Rice TW, Turrisi AT 3rd, Weick JK, et al. Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stage IIIA (N2), and IIIB non-small-cell lung cancer: Mature results of Southwest Oncology Group phase II study. J Clin Oncol 1995; 13: 1880–92.
Endo S, Sato Y, Hasegawa T, Tetsuka K, Otani S, Saito N, et al. Preoperative chemotherapy increases cytokine production after lung cancer surgery. Eur J Cardiothorac Surg 2004; 26: 787–91.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Endo, S., Tsubochi, H., Tetsuka, K. et al. Preoperative chemotherapy for cStage III-pN0 patients with non-small cell lung cancer. Jpn J Thorac Caridovasc Surg 54, 109–113 (2006). https://doi.org/10.1007/BF02744872
Issue Date:
DOI: https://doi.org/10.1007/BF02744872