Does Chemotherapy Before Surgery Affect Survival in Non-Small Cell Lung Cancer?

A study recently published in The Lancet Oncology examined the effect of chemotherapy before surgery on survival in non-small cell lung cancer. Analysis found a 5% improvement in 5-year survival and a delay in postoperative recurrence.

Lung cancer occurs when cells in one or both lungs multiply abnormally and uncontrollably to form a mass (tumor). Lung cancers are divided into 2 main groups according to their microscopic appearance: small cell lung cancer and non-small cell lung cancer. Small cell lung cancer is the less common group (25%), progresses rapidly and often cannot be treated surgically, while non-small cell lung cancer is more common (75%). If the disease is very advanced, surgery is not possible, and treatments such as radiotherapy and chemotherapy can only aim to prolong life. If it is not too advanced, the main strategy is to remove the tumor surgically. In some cases, radiotherapy and/or chemotherapy is then given for a time to destroy cells that cannot be seen and prevent recurrence. However, even in these patients, postoperative 5-year survival remains below the desired level. New treatment strategies are therefore needed to extend life and improve survival rates as much as possible.

Many studies have shown that chemotherapy after surgery prolongs survival in non-small cell lung cancer. However, the effect of chemotherapy before surgery is debated. It may shrink the tumor, prevent spread and make surgery more feasible, but if ineffective it can delay surgery and allow the tumor to become inoperable. These possibilities must therefore be weighed to determine whether preoperative chemotherapy is beneficial. A study recently published in The Lancet Oncology examined its effect on survival in non-small cell lung cancer.

The study compiled and analyzed data from 15 separate studies published in recent years, involving 2385 patients with non-small cell lung cancer. It compared surgery alone with chemotherapy before surgery. Analysis showed a 5% increase in 5-year survival with preoperative chemotherapy, which also delayed recurrence after surgery.

In conclusion, this study indicates that chemotherapy before surgery can improve 5-year survival in non-small cell lung cancer by 5%. This may initially seem small, but in a disease with such low survival, every advance that prolongs life is highly important.