Surgical treatment for locally advanced lung cancer; therapeutic response of induction chemotherapy and postoperative chemotherapy

摘要

The current chemotherapy has been able to give us many options to treat for lung cancer and recent studies have showed that perioperative chemotherapy may improve survival. In this study, we compared 2 groups with locally advanced lung cancers (stage III, T3N0M0, inclusive of ipsilateral PM2, D1 and D2) ; group A, which had been treated by chemotherapy for downstaging prior to surgery (n = 23), and group B, which had been treated by surgery alone (n = 48). The postoperative 3- and 5-year overall survival rates analyzed using the Kaplan-Meier method were 64.7 and 29.4% for group A, 32.5 and 10% for group B, respectively. And there was a significant difference between 2 groups. Further on patients with pN2, 3-year survival rate was 60% for group A and 36.7% for group B. In view of the progress of chemotherapy, even if the locally advanced lung cancer, which may be suspected of invasion to pulmonary artery, pulmonary vein and central bronchus, is not classified as T4, a patient with it should be performedan induction chemotherapy for downstaging and an operation for complete resection of the tumor and preserving lung function.