Endo Shunsuke, Tsubochi Hiroyoshi, Tetsuka Kenji, Sato Yukio, Hasegawa Tsuyoshi, Otani Shinichi, Saito Noriko, Sohara Yasunori
Division of General Thoracic Surgery, Department of Surgery, Jichi Medical School, Minamikawachi, Tochigi, Japan.
Jpn J Thorac Cardiovasc Surg. 2006 Mar;54(3):109-13. doi: 10.1007/BF02744872.
Survival benefits with preoperative chemotherapy for non-small cell lung cancer (NSCLC) remain controversial. Preoperative chemotherapy may act on micrometastasis but not lymph node metastasis. To clarify the role of induction chemotherapy for control of micrometastasis, we reviewed and compared 5-year follow-ups of clinical stage III but pathologically-proven node-negative NSCLC patients after complete resection with or without preoperative chemotherapy.
We reviewed 148 consecutive patients who underwent anatomical lung resection and mediastinal nodal dissection for pathologically-proven node-negative NSCLC at our hospital between 1994 and 1999. Fifty-six patients were preoperatively diagnosed as stage III: 26 received platinum-based chemotherapy prior to surgery (PCT group) and 30 underwent surgery without any prior chemotherapy (PRS group).
The 5-year survival rate for clinical stage I/II and pathological node-negative patients was 74.9%; for clinical stage III, but for pathological node-negative patients it was 92.3% in the PCT and 63.3% in the PRS groups. The survival benefit of preoperative chemotherapy was significant for clinical stage II patients without node involvement.
Preoperative chemotherapy may provide survival benefits for node-negative NSCLC patients.
非小细胞肺癌（NSCLC）术前化疗的生存获益仍存在争议。术前化疗可能作用于微转移，但对淋巴结转移无效。为阐明诱导化疗在控制微转移中的作用，我们回顾并比较了临床分期为III期但经病理证实淋巴结阴性的NSCLC患者在接受完全切除后，有或无术前化疗的5年随访情况。
我们回顾了1994年至1999年间在我院接受解剖性肺切除和纵隔淋巴结清扫术以确诊为淋巴结阴性NSCLC的148例连续患者。56例患者术前诊断为III期：26例在手术前接受了铂类化疗（PCT组），30例未接受任何术前化疗直接接受手术（PRS组）。
临床分期为I/II期且病理淋巴结阴性患者的5年生存率为74.9%；临床分期为III期但病理淋巴结阴性患者中，PCT组为92.3%，PRS组为63.3%。术前化疗对无淋巴结受累的临床II期患者的生存获益显著。
术前化疗可能为淋巴结阴性的NSCLC患者带来生存获益。
