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   <dc:title>Prognostic factors in neoadjuvant treatment followed by surgery in stage IIIA-N2 non-small cell lung cancer: a multi-institutional study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society)</dc:title>
   <dc:creator>Couñago, Felipe</dc:creator>
   <dc:creator>Alcántara Carrió, María Del Pino</dc:creator>
   <dc:creator>Rodríguez de Dios, Nuria</dc:creator>
   <dcterms:abstract>Purpose
To evaluate the prognostic factors associated with survival in patients treated with neoadjuvant treatment [chemoradiotherapy (CRT) or chemotherapy] followed by surgery (CRTS) in patients with stage IIIA-N2 non-small cell lung cancer (NSCLC).

Methods
A retrospective study was conducted of 118 patients diagnosed with stage T1-T3N2M0 NSCLC and treated with CRTS at 14 hospitals in Spain between January 2005 and December 2014. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method and compared using the log-rank test. Cox regression analysis was performed.

Results
Surgery consisted of lobectomy (74.5% of cases), pneumectomy (17.8%), or bilobectomy (7.6%). Neoadjuvant treatment was CRT in 62 patients (52.5%) and chemotherapy alone in 56 patients (47.5%). Median follow-up was 42.5 months (5–128 months). 5-year OS and PFS were 51.1% and 49.4%, respectively. The following variables were independently associated with worse OS and PFS: pneumonectomy (vs. lobectomy); advanced pathologic T stage (pT3 vs. pT0–pT2); and presence of persistent N2 disease (vs. ypN0-1) in the surgical specimen.

Conclusions
In this sample of patients with stage IIIA-N2 NSCLC treated with CRTS, 5-year survival (both OS and PFS) was approximately 50%. After CRTS, the patients with the best prognosis were those whose primary tumour and/or mediastinal nodal metastases were downstaged after induction therapy and those who underwent lobectomy. These findings provide further support for neoadjuvant therapy followed by surgery in selected patients.</dcterms:abstract>
   <dcterms:dateAccepted>2024-02-08T11:02:03Z</dcterms:dateAccepted>
   <dcterms:available>2024-02-08T11:02:03Z</dcterms:available>
   <dcterms:created>2024-02-08T11:02:03Z</dcterms:created>
   <dcterms:issued>2018</dcterms:issued>
   <dc:type>journal article</dc:type>
   <dc:identifier>https://hdl.handle.net/20.500.14352/100321</dc:identifier>
   <dc:identifier>1699-048X</dc:identifier>
   <dc:identifier>10.1007/s12094-018-1976-3</dc:identifier>
   <dc:identifier>1699-3055</dc:identifier>
   <dc:language>eng</dc:language>
   <dc:relation>Couñago, F., Montemuiño, S., Martin, M. et al. Prognostic factors in neoadjuvant treatment followed by surgery in stage IIIA-N2 non-small cell lung cancer: a multi-institutional study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society). Clin Transl Oncol 21, 735–744 (2019).</dc:relation>
   <dc:rights>http://creativecommons.org/licenses/by-nc-nd/4.0/</dc:rights>
   <dc:rights>open access</dc:rights>
   <dc:rights>Attribution-NonCommercial-NoDerivatives 4.0 International</dc:rights>
   <dc:publisher>Springer Link</dc:publisher>
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