Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study

Betticher, D C; Hsu Schmitz, S-F; Totsch, Martin; Hansen, E; Joss, C; von Briel, C; Schmid, R A; Pless, M; Habicht, J; Roth, Arnaud; Spiliopoulos, Anastase; Stahel, R; Weder, W; Stupp, R; Egli, F; Furrer, M; Honegger, H; Wernli, M; Cerny, T; Ris, H-B

doi:10.1038/sj.bjc.6603075

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Title		Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study
Authors		Betticher, D C Hsu Schmitz, S-F Totsch, Martin Hansen, E Joss, C von Briel, C Schmid, R A Pless, M Habicht, J Roth, Arnaud Spiliopoulos, Anastase Stahel, R Weder, W Stupp, R Egli, F Furrer, M Honegger, H Wernli, M Cerny, T Ris, H-B show all authors [1 - 20]
Published in		British Journal of Cancer. 2006, vol. 94, no. 8, p. 1099-106
Abstract		The aim was to investigate the efficacy of neoadjuvant docetaxel-cisplatin and identify prognostic factors for outcome in locally advanced stage IIIA (pN2 by mediastinoscopy) non-small-cell lung cancer (NSCLC) patients. In all, 75 patients (from 90 enrolled) underwent tumour resection after three 3-week cycles of docetaxel 85 mg m-2 (day 1) plus cisplatin 40 or 50 mg m-2 (days 1 and 2). Therapy was well tolerated (overall grade 3 toxicity occurred in 48% patients; no grade 4 nonhaematological toxicity was reported), with no observed late toxicities. Median overall survival (OS) and event-free survival (EFS) times were 35 and 15 months, respectively, in the 75 patients who underwent surgery; corresponding figures for all 90 patients enrolled were 28 and 12 months. At 3 years after initiating trial therapy, 27 out of 75 patients (36%) were alive and tumour free. At 5-year follow-up, 60 and 65% of patients had local relapse and distant metastases, respectively. The most common sites of distant metastases were the lung (24%) and brain (17%). Factors associated with OS, EFS and risk of local relapse and distant metastases were complete tumour resection and chemotherapy activity (clinical response, pathologic response, mediastinal downstaging). Neoadjuvant docetaxel-cisplatin was effective and tolerable in stage IIIA pN2 NSCLC, with chemotherapy contributing significantly to outcomes.
Keywords		Adult — Aged — Carcinoma, Non-Small-Cell Lung/diagnosis/drug therapy/surgery — Chemotherapy, Adjuvant — Cisplatin/therapeutic use — Combined Modality Therapy — Disease-Free Survival — Female — Follow-Up Studies — Humans — Lung Neoplasms/diagnosis/drug therapy/surgery — Male — Middle Aged — Neoplasm Recurrence, Local — Neoplasm Staging — Prognosis — Recurrence — Risk Assessment — Survival Rate — Taxoids/therapeutic use — Time Factors — Treatment Outcome
Identifiers		DOI: 10.1038/sj.bjc.6603075 PMID: 16622435
Full text		Article (Published version) (150 Kb) - Free access
Structures		Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de chirurgie
Research group		Groupe Roth Arnaud (oncologie) (285)
Citation (ISO format)		BETTICHER, D C et al. Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study. In: British Journal of Cancer, 2006, vol. 94, n° 8, p. 1099-106. doi: 10.1038/sj.bjc.6603075 https://archive-ouverte.unige.ch/unige:35895