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
To assess the activity of induction chemotherapy followed by surgery in stage IIIA and selected stage IIIB non-small-cell lung cancer patients. Mediastinoscopy proof of either positive N2 (IIIA) or T4N0-1 (IIIB) disease was required. Induction therapy was three cycles of cisplatin/gemcitabine/doceta...
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| Veröffentlicht in: | Journal of clinical oncology 2007-10, Vol.25 (30), p.4736-4742 |
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| creator | Garrido, Pilar González-Larriba, José Luis Insa, Amelia Provencio, Mariano Torres, Antonio Isla, Dolores Sanchez, José Miguel Cardenal, Felipe Domine, Manuel Barcelo, Jose Ramon Tarrazona, Vicente Varela, Andres Aguilo, Rafael Astudillo, Julio Muguruza, Ignacio Artal, Angel Hernando-Trancho, Florentino Massuti, Bartomeu Sanchez-Ronco, Maria Rosell, Rafael |
| description | To assess the activity of induction chemotherapy followed by surgery in stage IIIA and selected stage IIIB non-small-cell lung cancer patients.
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.
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.
Induction chemotherapy followed by surgery is effective in stage IIIA and in selected stage IIIB patients attaining complete resection. |
| doi_str_mv | 10.1200/JCO.2007.12.0014 |
| format | Article |
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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.
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.
Induction chemotherapy followed by surgery is effective in stage IIIA and in selected stage IIIB patients attaining complete resection.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.2007.12.0014</identifier><identifier>PMID: 17947721</identifier><language>eng</language><publisher>United States: American Society of Clinical Oncology</publisher><subject>Adenocarcinoma - drug therapy ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Carcinoma, Large Cell - drug therapy ; Carcinoma, Large Cell - pathology ; Carcinoma, Large Cell - surgery ; Carcinoma, Non-Small-Cell Lung - drug therapy ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - surgery ; Carcinoma, Squamous Cell - drug therapy ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Cisplatin - administration & dosage ; Combined Modality Therapy ; Deoxycytidine - administration & dosage ; Deoxycytidine - analogs & derivatives ; Female ; Humans ; Lung Neoplasms - drug therapy ; Lung Neoplasms - pathology ; Lung Neoplasms - surgery ; Male ; Middle Aged ; Neoplasm Staging ; Remission Induction ; Survival Rate ; Taxoids - administration & dosage</subject><ispartof>Journal of clinical oncology, 2007-10, Vol.25 (30), p.4736-4742</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c371t-97a1f04225339794916ba1f8100b76d1017e455b9464df5d8ed0306d6207b4ee3</citedby><cites>FETCH-LOGICAL-c371t-97a1f04225339794916ba1f8100b76d1017e455b9464df5d8ed0306d6207b4ee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3729,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17947721$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Garrido, Pilar</creatorcontrib><creatorcontrib>González-Larriba, José Luis</creatorcontrib><creatorcontrib>Insa, Amelia</creatorcontrib><creatorcontrib>Provencio, Mariano</creatorcontrib><creatorcontrib>Torres, Antonio</creatorcontrib><creatorcontrib>Isla, Dolores</creatorcontrib><creatorcontrib>Sanchez, José Miguel</creatorcontrib><creatorcontrib>Cardenal, Felipe</creatorcontrib><creatorcontrib>Domine, Manuel</creatorcontrib><creatorcontrib>Barcelo, Jose Ramon</creatorcontrib><creatorcontrib>Tarrazona, Vicente</creatorcontrib><creatorcontrib>Varela, Andres</creatorcontrib><creatorcontrib>Aguilo, Rafael</creatorcontrib><creatorcontrib>Astudillo, Julio</creatorcontrib><creatorcontrib>Muguruza, Ignacio</creatorcontrib><creatorcontrib>Artal, Angel</creatorcontrib><creatorcontrib>Hernando-Trancho, Florentino</creatorcontrib><creatorcontrib>Massuti, Bartomeu</creatorcontrib><creatorcontrib>Sanchez-Ronco, Maria</creatorcontrib><creatorcontrib>Rosell, Rafael</creatorcontrib><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</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>To assess the activity of induction chemotherapy followed by surgery in stage IIIA and selected stage IIIB non-small-cell lung cancer patients.
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.
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.
Induction chemotherapy followed by surgery is effective in stage IIIA and in selected stage IIIB patients attaining complete resection.</description><subject>Adenocarcinoma - drug therapy</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Carcinoma, Large Cell - drug therapy</subject><subject>Carcinoma, Large Cell - pathology</subject><subject>Carcinoma, Large Cell - surgery</subject><subject>Carcinoma, Non-Small-Cell Lung - drug therapy</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Carcinoma, Squamous Cell - drug therapy</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Cisplatin - administration & dosage</subject><subject>Combined Modality Therapy</subject><subject>Deoxycytidine - administration & dosage</subject><subject>Deoxycytidine - analogs & derivatives</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Remission Induction</subject><subject>Survival Rate</subject><subject>Taxoids - administration & dosage</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkcFu1DAURSMEokNhzwp5Be0igx07ccJuiKAMGk0RMwh2lpO8TFwldrCdou74Bz6q_9EvwdGMhFg93afzrp7ujaKXBC9JgvHbz-X1Mkwe1BJjwh5FC5ImPOY8TR9HC8xpEpOc_jiLnjl3MxM5TZ9GZ4QXjPOELKL7jdGHeA92QLvJ3qpb2aOVc6ZW0kODvivfodIMYw8e0FdwUHtlNFq1Hixa62Y66rKDwfgOrBzvkNJo5-UB0Hq9XqGLbXKJpG5m9R5d7NkWx-QSbY1--P1nN8i-j0voe7SZ9AGVUtfB-Iv0CrR379C-A7QbpVau-4-4smYa0d6q8G9RYPI8etLK3sGL0zyPvn38sC8_xZvrq3W52sQ15cTHBZekxSxJUkqLEEJBsipscoJxxbOGYMKBpWlVsIw1bdrk0GCKsyZLMK8YAD2PXh99R2t-TuC8GJSrw_9Sg5mcyHKGc5alAcRHsLbGOQutGK0apL0TBIu5PBHKE3N5QYm5mnDy6uQ9VQM0_w5ObQXgzRHo1KH7pSwIN-cX8ETc1CZJBcWCcZrRv6QXoJ8</recordid><startdate>20071020</startdate><enddate>20071020</enddate><creator>Garrido, Pilar</creator><creator>González-Larriba, José Luis</creator><creator>Insa, Amelia</creator><creator>Provencio, Mariano</creator><creator>Torres, Antonio</creator><creator>Isla, Dolores</creator><creator>Sanchez, José Miguel</creator><creator>Cardenal, Felipe</creator><creator>Domine, Manuel</creator><creator>Barcelo, Jose Ramon</creator><creator>Tarrazona, Vicente</creator><creator>Varela, Andres</creator><creator>Aguilo, Rafael</creator><creator>Astudillo, Julio</creator><creator>Muguruza, Ignacio</creator><creator>Artal, Angel</creator><creator>Hernando-Trancho, Florentino</creator><creator>Massuti, Bartomeu</creator><creator>Sanchez-Ronco, Maria</creator><creator>Rosell, Rafael</creator><general>American Society of Clinical Oncology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20071020</creationdate><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</title><author>Garrido, Pilar ; 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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.
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.
Induction chemotherapy followed by surgery is effective in stage IIIA and in selected stage IIIB patients attaining complete resection.</abstract><cop>United States</cop><pub>American Society of Clinical Oncology</pub><pmid>17947721</pmid><doi>10.1200/JCO.2007.12.0014</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Society of Clinical Oncology Online Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adenocarcinoma - drug therapy Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Carcinoma, Large Cell - drug therapy Carcinoma, Large Cell - pathology Carcinoma, Large Cell - surgery Carcinoma, Non-Small-Cell Lung - drug therapy Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - surgery Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Cisplatin - administration & dosage Combined Modality Therapy Deoxycytidine - administration & dosage Deoxycytidine - analogs & derivatives Female Humans Lung Neoplasms - drug therapy Lung Neoplasms - pathology Lung Neoplasms - surgery Male Middle Aged Neoplasm Staging Remission Induction Survival Rate Taxoids - administration & dosage |
| 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 |
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