title: [Resected non-small cell bronchogenic carcinoma stage pIIIA-N2. Which patients will benefit most from adjuvant therapy?].
abstract: BACKGROUND
  Controversy persists as regards the indications and results of surgery in the treatment of patients with stage pIIIA-N2 non-small cell lung cancer (NSCLC). The objective of this study was to analyze the overall survival of a multicentre series of these patients and the role of adjuvant treatment, looking for factors that may define subgroups of patients with an increased benefit from this treatment.
  
  
  METHODS
  A retrospective study was conducted on 287 patients, with stage pIIIA-N2 NSCLC subjected to complete resection, taken from a multi-institutional database of 2.994 prospectively collected consecutive patients who underwent surgery for lung cancer. Adjuvant treatment was administered in 238 cases (82.9%). Analyses were made of the age, gender, histological type, administration of induction and adjuvant chemotherapy and/or radiation therapy treatments.
  
  
  RESULTS
  The 5-year survival was 24%, with a median survival of 22 months. Survival was 26.5% among patients receiving with adjuvant treatment, versus 10.7% for those without it (P=.069). Age modified the effect of adjuvant treatment on survival (interaction P=.049). In patients under 70 years of age with squamous cell carcinoma, adjuvant treatment reduced the mortality rate by 37% (hazard ratio: 0,63; 95% CI; 0,42-0,95; P=.036).
  
  
  CONCLUSIONS
  Completely resected patients with stage pIIIA-N2 NSCLC receiving adjuvant treatment reached higher survival rates than those who did not. Maximum benefit was achieved by the subgroup of patients under 70 years of age with squamous cell carcinoma.
authors: Servicio de Cirugía General II y Cirugía Torácica, Hospital Clínico San Carlos, Madrid, España. Electronic address: agm912@hotmail.com.
authors: Ana M
authors: AM
authors: Gómez
authors: Servicio de Cirugía General II y Cirugía Torácica, Hospital Clínico San Carlos, Madrid, España.
authors: José Ramón
authors: JR
authors: Jarabo
authors: Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España.
authors: Cristina
authors: C
authors: Fernandez
authors: Servicio de Cirugía General II y Cirugía Torácica, Hospital Clínico San Carlos, Madrid, España.
authors: Joaquín
authors: J
authors: Calatayud
authors: Servicio de Cirugía General II y Cirugía Torácica, Hospital Clínico San Carlos, Madrid, España.
authors: Elena
authors: E
authors: Fernández
authors: Servicio de Cirugía General II y Cirugía Torácica, Hospital Clínico San Carlos, Madrid, España.
authors: Antonio J
authors: AJ
authors: Torres
authors: Servicio de Cirugía General II y Cirugía Torácica, Hospital Clínico San Carlos, Madrid, España.
authors: José L
authors: JL
authors: Balibrea
authors: Servicio de Cirugía General II y Cirugía Torácica, Hospital Clínico San Carlos, Madrid, España.
authors: Florentino
authors: F
authors: Hernando
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Adjuvant treatment; Adyuvancia; Cirugía; Cáncer de pulmón; Estadio IIIA; Lung cancer; N2; Stage IIIA; Supervivencia; Surgery; Survival