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Nodal downstaging predicts survival following induction chemotherapy for stage IIIA (N2) non-small cell lung cancer in CALGB protocol #8935.

Publication ,  Journal Article
Jaklitsch, MT; Herndon, JE; DeCamp, MM; Richards, WG; Kumar, P; Krasna, MJ; Green, MR; Sugarbaker, DJ
Published in: J Surg Oncol
December 1, 2006

BACKGROUND AND OBJECTIVES: CALGB 8935 was a phase II protocol for mediastinoscopically staged IIIA (N2) non-small cell lung cancer. Induction cisplatin/vinblastine chemotherapy was followed by surgical resection, adjuvant cisplatin/vinblastine, and radiotherapy. We now evaluate the prognosis of pathologic nodes. METHODS: Failure-free survival was calculated from a landmark 3 months after resection to account for heterogeneity in adjuvant therapy. RESULTS: Nine of 42 (21%) resected patients had no residual N2 disease. This subset of 9 had a median failure-free interval of 47.8 months from landmark, whereas the 33 patients (79%) with persistent N2 disease had a median failure-free survival of 8.2 months from landmark (P=0.01). Although 21/42 (50%) had an incomplete resection (positive highest resected node and/or margin), completeness of resection did not influence failure-free survival. There were 3 distant and no local recurrences among the N2 negative group, and 12 local recurrences among patients with residual N2 disease (P=0.041). CONCLUSIONS: These data suggest: (1) persistent N2 disease following induction chemotherapy is unfavorable; (2) patients downstaged to N2 negative may benefit from surgical resection; however, (3) 33% of N2 negative patients suffered disease relapse.

Duke Scholars

Published In

J Surg Oncol

DOI

ISSN

0022-4790

Publication Date

December 1, 2006

Volume

94

Issue

7

Start / End Page

599 / 606

Location

United States

Related Subject Headings

  • Vinblastine
  • Survival Rate
  • Radiotherapy, Adjuvant
  • Radiotherapy Dosage
  • Prognosis
  • Predictive Value of Tests
  • Pneumonectomy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Multivariate Analysis
 

Citation

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Jaklitsch, M. T., Herndon, J. E., DeCamp, M. M., Richards, W. G., Kumar, P., Krasna, M. J., … Sugarbaker, D. J. (2006). Nodal downstaging predicts survival following induction chemotherapy for stage IIIA (N2) non-small cell lung cancer in CALGB protocol #8935. J Surg Oncol, 94(7), 599–606. https://doi.org/10.1002/jso.20644
Jaklitsch, Michael T., James E. Herndon, Malcolm M. DeCamp, William G. Richards, Parvesh Kumar, Mark J. Krasna, Mark R. Green, and David J. Sugarbaker. “Nodal downstaging predicts survival following induction chemotherapy for stage IIIA (N2) non-small cell lung cancer in CALGB protocol #8935.J Surg Oncol 94, no. 7 (December 1, 2006): 599–606. https://doi.org/10.1002/jso.20644.
Jaklitsch MT, Herndon JE, DeCamp MM, Richards WG, Kumar P, Krasna MJ, et al. Nodal downstaging predicts survival following induction chemotherapy for stage IIIA (N2) non-small cell lung cancer in CALGB protocol #8935. J Surg Oncol. 2006 Dec 1;94(7):599–606.
Jaklitsch, Michael T., et al. “Nodal downstaging predicts survival following induction chemotherapy for stage IIIA (N2) non-small cell lung cancer in CALGB protocol #8935.J Surg Oncol, vol. 94, no. 7, Dec. 2006, pp. 599–606. Pubmed, doi:10.1002/jso.20644.
Jaklitsch MT, Herndon JE, DeCamp MM, Richards WG, Kumar P, Krasna MJ, Green MR, Sugarbaker DJ. Nodal downstaging predicts survival following induction chemotherapy for stage IIIA (N2) non-small cell lung cancer in CALGB protocol #8935. J Surg Oncol. 2006 Dec 1;94(7):599–606.
Journal cover image

Published In

J Surg Oncol

DOI

ISSN

0022-4790

Publication Date

December 1, 2006

Volume

94

Issue

7

Start / End Page

599 / 606

Location

United States

Related Subject Headings

  • Vinblastine
  • Survival Rate
  • Radiotherapy, Adjuvant
  • Radiotherapy Dosage
  • Prognosis
  • Predictive Value of Tests
  • Pneumonectomy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Multivariate Analysis