Preoperative chemotherapy for cStage III-pN0 patients with non-small cell lung cancer.
OBJECTIVE
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 II patients without node involvement.


CONCLUSIONS
Preoperative chemotherapy may provide survival benefits for node-negative NSCLC patients.
Endo
Shunsuke
S
Division of General Thoracic Surgery, Department of Surgery, Jichi Medical School, Minamikawachi, Tochigi, Japan.
Tsubochi
Hiroyoshi
H
Tetsuka
Kenji
K
Sato
Yukio
Y
Hasegawa
Tsuyoshi
T
Otani
Shinichi
S
Saito
Noriko
N
Sohara
Yasunori
Y
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D015996:Survival Rate