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Ann Thorac Surg 1999;68:1821-1826
© 1999 The Society of Thoracic Surgeons

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Original Articles

Postoperative adjuvant therapy for stage II non–small-cell lung cancer

^a Department of Thoracic Surgery, Korea Cancer Center Hospital, Seoul, South Korea
^b Department of Radiation Oncology, Korea Cancer Center Hospital, Seoul, South Korea
^c Department of Diagnostic Radiology, Korea Cancer Center Hospital, Seoul, South Korea
^d Department of Pathology, Korea Cancer Center Hospital, Seoul, South Korea
^e Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, South Korea

Address reprint requests to Dr Zo, Department of Thoracic Surgery, Korea Cancer Center Hospital, 215-4, Gongneung-Dong, Nowon-Ku, Seoul, 139-706, Korea
e-mail: jaylzo{at}kcchsun.kcch.re.kr

Background. Stage II non–small-cell lung cancer is regarded as one of the early lung cancers. Although resection, including the mediastinal lymph nodes, is currently regarded as the standard treatment, the survival rate of this disease is not encouraging. It is well known that the most common causes of death are locoregional recurrences or distant metastases, or both. However, the best adjuvant treatment to improve survival is as controversial an issue as ever.

Methods. This study was designed as a randomized, blinded, two-armed study with operation and adjuvant radiotherapy in one arm, versus operation and adjuvant mitomycin C (10 mg/m²), vinblastin (6 mg/m²), and cisplatin (100 mg/m²) (MVP) chemotherapy in the other arm. We assigned 57 resected patients with pathologic proven stage II non-small cell lung cancer to the groups according to our eligibility criteria.

Results. The most common pattern of recurrence was distant metastases, and nearly all the recurrences (17 of 18 patients) in both groups were found within 2 years after operation. The rates of the locoregional and distant metastases were 3.6% and 46.4% in the adjuvant radiotherapy group and 6.9% and 10.3% in the adjuvant chemotherapy group (p = 0.018). The 5-year disease-free survival rates were 52.0% in the adjuvant radiotherapy group and 74.0% in the adjuvant chemotherapy group (p = 0.16, log-rank test). The 2-year, 5-year, and 6-year survival portions were 60.3%, 56.5%, and 28.3% in the adjuvant radiotherapy group, and 82.8%, 70.1%, and 60.1% in the adjuvant chemotherapy group (p = 0.01, p = 0.17, and p = 0.03, Z-test). The difference of the actuarial survival between these two groups was somewhat significant (p = 0.09, log-rank test).

Conclusions. Our results suggest that the addition of adjuvant MVP chemotherapy may reduce the distant metastasis rates and prolong the survival of the surgically resected stage II non–small-cell lung cancer patients.

This article has been cited by other articles:

				J. H. Park, C.-T. Lee, H. W. Lee, H. J. Baek, J. I. Zo, and Y. M. Shim Postoperative adjuvant chemotherapy for stage I non-small cell lung cancer Eur. J. Cardiothorac. Surg., June 1, 2005; 27(6): 1086 - 1091. [Abstract] [Full Text] [PDF]

				M. Alifano, G. Benedetti, and R. Trisolini Can Low-Molecular-Weight Heparin Improve the Outcome of Patients With Operable Non-Small Cell Lung Cancer?: An Urgent Call for Research Chest, August 1, 2004; 126(2): 601 - 607. [Full Text] [PDF]