Adjuvant therapy in stage IIIA-N2 non-small cell lung cancer after neoadjuvant concurrent chemoradiotherapy followed by surgery.

Content Provider	Europe PMC
Author	Shin, Sumin Kim, Hong Kwan Cho, Jong Ho Choi, Yong Soo Kim, Kwhanmien Kim, Jhingook Zo, Jae Ill Sun, Jong-Mu Ahn, Myung-Ju Park, Keunchil Pyo, Hongryull Ahn, Yong Chan Shim, Young Mog
Copyright Year	2020
Abstract	BackgroundThis study aimed to determine whether adjuvant therapy improves survival in patients with stage IIIA-N2 non-small cell lung cancer (NSCLC) after neoadjuvant concurrent chemoradiotherapy (CCRT) followed by surgery.MethodsWe retrospectively reviewed 467 consecutive patients with stage IIIA-N2 NSCLC who received neoadjuvant CCRT followed by surgery between 2004 and 2013. From these, we identified 398 eligible patients and their clinical outcomes were compared according to whether adjuvant therapy was provided.ResultsIn total, 296 patients (74%) received adjuvant therapy consisting of chemotherapy alone (n=71) radiotherapy alone (n=118) and both chemotherapy and radiotherapy (n=107). Adjuvant therapy was not given to remaining 102 patients. Patients who receiving adjuvant therapy were significantly younger (P=0.001), and predominantly male (P=0.014) compared to patients who did not receive adjuvant therapy. Regarding to the pathologic response, the adjuvant therapy group had a significantly poor pathologic response. However, the 5-year overall survival (OS) rate did not significantly differ between the groups (adjuvant therapy group, 52.9%; no adjuvant therapy group, 54.9%; P=0.369). After adjusting for age, sex, type of operation, cell type and yp stage, adjuvant therapy was significantly associated with better OS (hazard ratio =0.59; 95% CI, 0.38–0.92; P=0.019) and disease free survival (hazard ratio =0.62; 95% CI, 0.44–0.87; P=0.006).ConclusionsOur data indicate that adjuvant therapy is more often given to patients with poor pathologic findings. Adjuvant treatment after trimodal therapy is a significant predictor of survival after adjustment of clinical variables.
ISSN	20721439
Journal	Journal of Thoracic Disease
Volume Number	12
PubMed Central reference number	PMC7330356
Issue Number	5
PubMed reference number	32642168
e-ISSN	20776624
DOI	10.21037/jtd.2020.03.23
Language	English
Publisher	AME Publishing Company
Publisher Date	2020-05-01
Access Restriction	Open
Rights License	Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0. 2020 Journal of Thoracic Disease. All rights reserved.
Subject Keyword	Chemotherapy radiotherapy non-small cell lung cancer (NSCLC) surgery outcomes
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine