title: Long-term survival associated with complete resection after induction chemotherapy in stage IIIA (N2) and IIIB (T4N0-1) non small-cell lung cancer patients: the Spanish Lung Cancer Group Trial 9901.
abstract: OBJECTIVE
  To assess the activity of induction chemotherapy followed by surgery in stage IIIA and selected stage IIIB non-small-cell lung cancer patients.
  
  
  METHODS
  Mediastinoscopy proof of either positive N2 (IIIA) or T4N0-1 (IIIB) disease was required. Induction therapy was three cycles of cisplatin/gemcitabine/docetaxel, followed by surgery.
  
  
  RESULTS
  From December 1999 to March 2003, 136 patients were entered onto the study; the clinical response rate in 129 assessable patients was 56%. The overall complete resection rate was 68.9% of patients eligible for surgery (72% of stage IIIA patients and 66% of stage IIIB patients) and 48% of all assessable patients. Eight (12.9%) of 62 completely resected patients had a pathologic complete response. Seven patients (7.8%) died during the postoperative period. The median overall survival time was 15.9 months, 3-year survival rate was 36.8%, and 5-year survival rate was 21.1%, with no significant differences in survival between stage IIIA and stage IIIB patients. Median survival time was 48.5 months for 62 completely resected patients, 12.9 months for 13 incompletely resected patients, and 16.8 months for 15 nonresected patients (P = .005). Three- and 5-year survival rates were 60.1% and 41.4% for completely resected patients, 23.1% and 11.5% for incompletely resected patients, and 31.1% and 0% for nonresected patients, respectively. In the multivariate analysis, complete resection (hazard ratio [HR] = 0.35; P < .0001), clinical response (HR = 0.32; P < .0001), and age younger than 60 years (HR = 0.64; P = .027) were the most powerful prognostic factors.
  
  
  CONCLUSIONS
  Induction chemotherapy followed by surgery is effective in stage IIIA and in selected stage IIIB patients attaining complete resection.
authors.affiliation: Hospital Ramon y Cajal, Madrid, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Garrido
authors.forename: José Luis
authors.initials: JL
authors.lastname: González-Larriba
authors.forename: Amelia
authors.initials: A
authors.lastname: Insa
authors.forename: Mariano
authors.initials: M
authors.lastname: Provencio
authors.forename: Antonio
authors.initials: A
authors.lastname: Torres
authors.forename: Dolores
authors.initials: D
authors.lastname: Isla
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Sanchez
authors.forename: Felipe
authors.initials: F
authors.lastname: Cardenal
authors.forename: Manuel
authors.initials: M
authors.lastname: Domine
authors.forename: Jose Ramon
authors.initials: JR
authors.lastname: Barcelo
authors.forename: Vicente
authors.initials: V
authors.lastname: Tarrazona
authors.forename: Andres
authors.initials: A
authors.lastname: Varela
authors.forename: Rafael
authors.initials: R
authors.lastname: Aguilo
authors.forename: Julio
authors.initials: J
authors.lastname: Astudillo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Muguruza
authors.forename: Angel
authors.initials: A
authors.lastname: Artal
authors.forename: Florentino
authors.initials: F
authors.lastname: Hernando-Trancho
authors.forename: Bartomeu
authors.initials: B
authors.lastname: Massuti
authors.forename: Maria
authors.initials: M
authors.lastname: Sanchez-Ronco
authors.forename: Rafael
authors.initials: R
authors.lastname: Rosell
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018287:Carcinoma, Large Cell / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012074:Remission Induction; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D002945:Cisplatin; D000093542:Gemcitabine