Long-term results of combined-modality therapy in resectable non-small-cell lung cancer Journal Article
| Authors: | Martin, J.; Ginsberg, R. J.; Venkatraman, E. S.; Bains, M. S.; Downey, R. J.; Korst, R. J.; Kris, M. G.; Rusch, V. W. |
| Article Title: | Long-term results of combined-modality therapy in resectable non-small-cell lung cancer |
| Abstract: | Purpose: Assessment of long-term results of combined-modality therapy for resectable non-small-cell lung cancer is hampered by insufficient follow-up and small patient numbers. To evaluate this, we reviewed our collective experience. Patients and Methods: This study was a retrospective chart review recording demographics, tumor stage, treatment, and outcome of consecutive patients undergoing surgery. Survival was analyzed by Kaplan-Meier, and prognostic factors were analyzed by logrank and Cox regression. Results: From January 1993 to December 1999, 470 patients were treated, with follow-up in 446: 27 stage I, 55 stage II, 316 stage III, 43 stage IV (solitary M1), and five uncertain. Chemotherapy was mitomycin/vinblastine/cisplatin (174 patients [39.0%]), carboplatin/ paclitaxel (148 [33.2%]), and other combination (124 [27.8%]); 75 patients (16.8%) received induction radiation. Resection was complete in 77.4%, incomplete in 8.3%, attempted but with gross residual disease afterward in 1.8%, and not performed in 12.6%. Pathologic complete response occurred in 20 patients (4.5%). With median follow-up of 31.0 months for patients still alive, median and 3-year survival for pathologic stages 0, I, II, III, and IV were more than 90 months, 73%; 42 months, 52%; 23 months, 35%; 16 months, 28%; and 16 months, 23% (P < .001). In a multivariate analysis, age, complete resection, pathologic stage, and pneumonectomy, but not induction regimen, significantly influenced survival. Conclusion: Although pathologic complete response outside the protocol setting is low, survival of this large patient cohort is comparable to that of patients in published combined-modality trials. Survival is significantly influenced by patient age, complete resection, pathologic stage, and pneumonectomy. These results can help guide standard clinical practice and emphasize the need for novel induction regimens. © 2002 by American Society of Clinical Oncology. |
| Keywords: | adult; cancer survival; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; retrospective studies; major clinical study; cisplatin; cancer combination chemotherapy; paclitaxel; cancer radiotherapy; combined modality therapy; carboplatin; lung non small cell cancer; antineoplastic combined chemotherapy protocols; carcinoma, non-small-cell lung; lung neoplasms; pneumonectomy; proportional hazards models; radiotherapy dosage; antineoplastic activity; vinblastine; mitomycin; humans; prognosis; human; male; female; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 20 |
| Issue: | 8 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2002-04-15 |
| Start Page: | 1989 |
| End Page: | 1995 |
| Language: | English |
| DOI: | 10.1200/jco.2002.08.092 |
| PUBMED: | 11956257 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 14 November 2014 -- Source: Scopus |
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