title: [Is there a place for surgical management in stage IIIA N2 non-small cell lung cancer?].
abstract: BACKGROUND
  Non-small cell lung cancer (NSCLC) remains a major health problem, with a 5-year overall survival of 25%. Surgical management of stage IIIA NSCLC is still controversial. We conduct a systematic analysis of the different management strategies for stage IIIA-N2 NSCLC.
  
  
  METHODS
  We analyzed randomized control trials published between January 1990 to December 2013, comparing induction chemotherapy followed by surgery vs. surgery alone, and those comparing induction chemo or radiotherapy followed by surgery vs. induction chemotherapy followed by radiotherapy for stage IIIA-N2 NSCLC.
  
  
  RESULTS
  A 16% significant increase in overall survival was found in favor of induction chemotherapy followed by surgery vs. surgery alone. However, there was no significant difference in overall survival between induction chemo- or radiotherapy followed by surgery and induction chemotherapy followed by radiotherapy.
  
  
  CONCLUSIONS
  Current scientific data do not permit the exclusion of surgery as an option in the management of stage IIIA-N2 NSCLC.
authors.affiliation: Service de chirurgie cardiovasculaire et thoracique, université de Bourgogne, CHU Bocage central, CHU de Dijon, BP 77908, 14, rue Gaffarel, 21079 Dijon cedex, France. Electronic address: pierrebenoit.pages@chu-dijon.fr.
authors.forename: P-B
authors.initials: PB
authors.lastname: Pagès
authors.affiliation: Service de chirurgie cardiovasculaire et thoracique, université de Bourgogne, CHU Bocage central, CHU de Dijon, BP 77908, 14, rue Gaffarel, 21079 Dijon cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Pforr
authors.affiliation: Service de chirurgie cardiovasculaire et thoracique, université de Bourgogne, CHU Bocage central, CHU de Dijon, BP 77908, 14, rue Gaffarel, 21079 Dijon cedex, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Delpy
authors.affiliation: Service de chirurgie cardiovasculaire et thoracique, université de Bourgogne, CHU Bocage central, CHU de Dijon, BP 77908, 14, rue Gaffarel, 21079 Dijon cedex, France.
authors.forename: H
authors.initials: H
authors.lastname: Abou Hanna
authors.affiliation: Service de chirurgie cardiovasculaire et thoracique, université de Bourgogne, CHU Bocage central, CHU de Dijon, BP 77908, 14, rue Gaffarel, 21079 Dijon cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Bernard
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Cancer bronchique non à petites cellules; Chimiothérapie d’induction; Chirurgie thoracique; Induction chemotherapy; Non-small cell lung cancer; Radiotherapy; Radiothérapie; Thoracic surgery