Couñago, F.Alcántara Carrió, María Del PinoCorona Sánchez, Juan AntonioTaboada, B.2024-02-082024-02-082018-02-15Couñago F, Rodriguez de Dios N, Montemuiño S, Jové-Teixidó J, Martin M, Calvo-Crespo P, López-Mata M, Samper-Ots MP, López-Guerra JL, García-Cañibano T, Díaz-Díaz V, de Ingunza-Barón L, Murcia-Mejía M, Alcántara P, Corona J, Puertas MM, Chust M, Couselo ML, Del Cerro E, Moradiellos J, Amor S, Varela A, Thuissard IJ, Sanz-Rosa D, Taboada B. Neoadjuvant treatment followed by surgery versus definitive chemoradiation 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). Lung Cancer. 2018 Apr;118:119-127. doi: 10.1016/j.lungcan.2018.02.008. Epub 2018 Feb 14.0169-500210.1016/j.lungcan.2018.02.008https://hdl.handle.net/20.500.14352/100379Objectives: The role of surgery in stage IIIA-N2 non-small cell lung cancer (NSCLC) is an actively debated in oncology. To evaluate the value of surgery in this patient population, we conducted a multi-institutional retrospective study comparing neoadjuvant chemoradiotherapy or chemotherapy plus surgery (CRTS) to definitive chemoradiotherapy (dCRT). Material and methods: A total of 247 patients with potentially resectable stage T1-T3N2M0 NSCLC treated with either CRTS or dCRT between January 2005 and December 2014 at 15 hospitals in Spain were identified. A centralized review was performed to ensure resectability. A propensity score matched analysis was carried out to balance patient and tumor characteristics (n = 78 per group). Results: Of the 247 patients, 118 were treated with CRTS and 129 with dCRT. In the CRTS group, 62 patients (52.5%) received neoadjuvant CRT and 56 (47.4%) neoadjuvant chemotherapy. Surgery consisted of either lobectomy (97 patients; 82.2%) or pneumonectomy (21 patients; 17.8%). In the matched samples, median overall survival (OS; 56 vs 29 months, log-rank p = .002) and progression-free survival (PFS; 46 vs 15 months, log-rank p < 0.001) were significantly higher in the CRTS group. This survival advantage for CRTS was maintained in the subset comparison between the lobectomy subgroup versus dCRT (OS: 57 vs 29 months, p < 0.001; PFS: 46 vs 15 months, p < 0.001), but not in the comparison between the pneumonectomy subgroup and dCRT. Conclusion: The findings reported here indicate that neoadjuvant chemotherapy or chemoradiotherapy followed by surgery (preferably lobectomy) yields better OS and PFS than definitive chemoradiotherapy in patients with resectable stage IIIA-N2 NSCLC.engjournal articlehttp://europepmc.org/abstract/med/2957198929571989https://pubmed.ncbi.nlm.nih.gov/29571989/restricted access615.849.1ChemoradiationNSCLCNeoadjuvant treatmentSurgeryStage IIIACiencias Biomédicas32 Ciencias Médicas