Thoracoscopic radical resection in the treatment of NSCLC patients (stage IIIA) after neoadjuvant chemotherapy.

PURPOSE

We aimed to investigate the efficacy and safety of thoracoscopic radical resection of lung cancer in the treatment of patients with stage IIIA non-small cell lung cancer (NSCLC) after neoadjuvant chemotherapy.

METHODS

A total of 132 NSCLC patients (stage IIIA) were collected. Among them, 66 received preoperative neoadjuvant chemotherapy and thoracoscopic radical resection of lung cancer (NACT group), and 66 underwent thoracoscopic radical resection of lung cancer directly (control group). Next, the downstaging of the tumor was analyzed after neoadjuvant chemotherapy, and the R0 resection rate, surgical conditions, postoperative complications, and changes in the levels of serum tumor markers were compared between the two groups of patients.

RESULTS

The response rate of neoadjuvant chemotherapy was 51.5% (34/66), and the overall downstaging rate was 53.0% (35/66) after neoadjuvant chemotherapy, with 34 cases of T downstaging and 35 cases of N downstaging. The operative time was clearly shorter in the NACT group than that in control group. The R0 resection rate in the NACT group was prominently higher than that in the the control group. The follow-up results uncovered that the 3-year overall survival (OS) and 3-year progression-free survival (PFS) rates were 50.0% and 21.2％ in the NACT group, and 36.4% and 6.1% in the control group, respectively. Based on the results of log-rank test, the OS and PFS of patients in the NACT group were markedly better than those in the control group.

CONCLUSIONS

Neoadjuvant chemotherapy benefits patients with NSCLC (stage IIIA), and it is capable of effectively leading to pathological down-staging, elevating the R0 resection rate, significantly improving the survival of patients and considerably repressing the progression of the disease.