title: [Impact of induction therapies on pathology and outcome after surgical resection of non-small lung cancer: a 30-year experience of 859 patients].
abstract: The management of localized non-small cell lung cancer (NSCLC) has been modified over the last decades, with induction therapies being increasingly recommended as a prerequisite to surgical resection. However, the relative impact of chemo- and chemoradiotherapy on tumours' pathology and patients' survival is still discussed.
  
  
  METHODS
  We set a retrospective study including every patient who underwent surgical resection for NSCLC in 2 French centres from 1980 to 2009. We then compared the tumours' pathology and patients' survival according to the use of induction chemotherapy (group 1) or induction chemoradiotherapy (group 2).
  
  
  RESULTS
  There were 733 patients in group 1 and 126 patients in group 2. In group 1, 669 patients (91%) had platinum-based chemotherapy, for 2 to 3 cycles in 564 cases (77%). In group 2, chemoradiotheray was concomitant in 68 patients (54%), and sequential in 58 patients (46%). As compared with group 1, group 2 was characterized by younger age (mean 59.8±9.5 vs 56.4±9.6, respectively, P<.001), a higher rate of tumours deemed unresectable before induction treatment (25% vs 44%, P<.001), and a higher proportion of T4 (25% vs 44%, P<.001) or N2 diseases (56% vs 69%, P=.005). The type of resection, postoperative complications, and postoperative mortality were not significantly different between groups. On final pathologic report, as compared with group 1, there were more N0 and N1 disease in group 2 (N0: 43% vs 58%, P=.002; N1: 22% vs 10%, P=.002) while the rate of N2 disease was comparable (34% vs 32%, P=ns). The median, 5-, and 10-year survivals were 28 months, 35%, and 21% for group 1, and 29 months, 36%, and 23% for group 2, respectively (P=ns).
  
  
  CONCLUSIONS
  As compared with induction chemotherapy, induction chemoradiotherapy was performed in more advanced NSCLC, and resulted in better downstaging, similar postoperative course, and comparable long-term outcome after surgical resection.
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Descartes, 20, rue Leblanc, 75015 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Mordant
authors.affiliation: Service d'oncologie médicale, hôpital européen Georges-Pompidou, université Descartes, 20, rue Leblanc, 75015 Paris, France.
authors.forename: É
authors.initials: É
authors.lastname: Fabre
authors.affiliation: Service d'anatomopathologie, hôpital européen Georges-Pompidou, université Descartes, 20, rue Leblanc, 75015 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Gibault
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Descartes, 20, rue Leblanc, 75015 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Arame
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Descartes, 20, rue Leblanc, 75015 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Pricopi
authors.affiliation: Service de chirurgie thoracique, centre médico-chirurgical du Cèdre, 76230 Bois-Guillaume, France.
authors.forename: A
authors.initials: A
authors.lastname: Dujon
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Descartes, 20, rue Leblanc, 75015 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Le Pimpec-Barthes
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Descartes, 20, rue Leblanc, 75015 Paris, France. Electronic address: marc.riquet@egp.aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Riquet
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011013:Pneumonectomy; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cancer bronchique non à petites cellules; Chemoradiation; Chimiothérapie; Induction chemotherapy; Non-small cell lung cancer; Radiochimiothérapie; Survie; Survival; Traitement néoadjuvant