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Neoadjuvant Chemotherapy and Surgical Treatment in Advanced Stages of Non-Small Cell Lung Cancer


Authors: M. Szkorupa;  J. Klein 1;  T. Bohanes;  Č. Neoral;  V. Kolek 2;  I. Grygárková 2
Authors‘ workplace: I. chirurgická klinika FN a LF UP Olomouc, přednosta: doc. MUDr. Č. Neoral, CSc. ;  Krajská nemocnice T. Bati, a. s., Zlín, primář: prof. MUDr. J. Klein, Ph. D. 1;  Klinika plicních nemocí a tuberkulózy FN a LF UP Olomouc, přednosta: prof. MUDr. V. Kolek, DrSc. 2
Published in: Rozhl. Chir., 2011, roč. 90, č. 8, s. 433-439.
Category: Monothematic special - Original

Overview

Introduction:
Lung cancer takes first place in both incidence and mortality in the Czech Republic. This is associated with the disease being diagnosed in late stages, which limits the possibility of radical therapy. Five-year survival of patients operated on with stage IIIA is low and doesn’t even reach 20%. These poor results and the development of systemic chemotherapy in the 1990’s led to an effort to treat locally advanced disease by administering chemotherapy before the surgical procedure- induction chemotherapy. Its benefit, however, unlike that of adjuvant chemotherapy, remains unclear.

Aim:
To analyze and compare the results between a set of patients with non-small cell lung cancer (NSCLC) with stage III A-B, operated on at the I. Department of Surgery at the University Hospital and Palacky Medical Faculty in Olomouc between the years 2000–2008, who underwent preoperative chemotherapy with the results of patients with stage III A-B diagnosed after the operation based on histological findings. Three- and five-year survivals, as well as survival median, were evaluated in both groups.

Results:
A statistically significant difference in survival between the two groups was not observed.

Conclusion:
Neoadjuvant chemotherapy remains controversial in the treatment of NSCLC. The initially promising results have not been unequivocally confirmed in later studies and its role remains a question to be answered in future extensive randomized studies.

Key words:
non-small cell lung cancer – surgical treatment – preoperative chemotherapy


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