Should induction chemotherapy be used for cT3 NSCLC?

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Takeaway

  • Induction chemotherapy is associated with increased rates of complete resection, but not improved survival for patients with T3N0M0 NSCLC.

Why this matters

  • Current guidelines on appropriate treatment are unclear.

Key results

  • Induction chemotherapy patients were more likely to undergo an open operative approach (87.3% vs 77.8%; P=.005) and less likely to have positive surgical margins (6.7% vs 10%; P=.040) compared with surgery-alone patients.
  • Induction therapy was associated with increased 90-d mortality (6.6% vs 3.4%; P=.003), but similar 5-y OS survival (49.3% vs 52.5%; P=.116) compared with surgery alone.

Study design

  • 3791 patients with cT3N0M0 NSCLC who underwent surgery, 15% treated with induction chemotherapy, were analyzed for associations between treatment modality and outcomes.
  • Funding: Institutional funding; National Institutes of Health.

Limitations

  • Retrospective database study.