A critical appraisal of the adjuvant chemotherapy guidelines for patients with completely resected T3N0 non-small-cell lung cancer

Acta Oncologica
Tommaso De PasPatrick Maisonneuve

Abstract

A Joint Expert Panel recently published guidelines for adjuvant cisplatin-based chemotherapy, recommending routine use in patients with completely resected stage II (T1-2N1 and T3N0) non-small-cell lung cancer (NSCLC). However, these two tumor subgroups should be considered as different entities. While the efficacy of adjuvant chemotherapy has been established in patients with T1-2N1 NSCLC, its benefit in patients with T3N0 tumor remains questionable. We performed an extensive review of the literature using the Joint Expert Panel guidelines as a start point. Altogether, we identified 76 potentially relevant articles. Basing on inclusion and exclusion criteria, 23 of the 76 articles were eventually included in this review. After careful evaluation of the selected articles, we found no information on the effect of adjuvant chemotherapy in patients with T3N0 NSCLC. In the absence of evidence-based data, we recommend that the lack of information on the efficacy of adjuvant chemotherapy for T3N0 tumors be discussed with patients and propose chemotherapy as an individual option. While the efficacy of adjuvant chemotherapy will be difficult to assess prospectively through a large randomized clinical trial, a pooled-analysis of the exi...Continue Reading

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Citations

Sep 21, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Makoto SuzukiIchiro Yoshino
Jan 13, 2012·World Journal of Surgical Oncology·Chang Young LeeIn Kyu Park
May 23, 2012·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Francesca ToffalorioTommaso De Pas
May 23, 2013·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Damien UrbanDavid Ball
Apr 28, 2010·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Tommaso De PasGiulia Veronesi
Mar 18, 2016·Journal of Radiation Research·Takahisa EriguchiNaoyuki Shigematsu

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