{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T21:17:07Z","timestamp":1788556627307,"version":"build-2803163510"},"reference-count":29,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2003,5,1]]},"abstract":"<jats:p> Purpose: A multicenter, phase II trial investigated the efficacy and toxicity of neoadjuvant docetaxel-cisplatin in locally advanced non\u2013small-cell lung cancer (NSCLC) and examined prognostic factors for patients not benefiting from surgery. <\/jats:p><jats:p> Patients and Methods: Ninety patients with previously untreated, potentially operable stage IIIA (mediastinoscopically pN2) NSCLC received three cycles of docetaxel 85 mg\/m<jats:sup>2<\/jats:sup> day 1 plus cisplatin 40 mg\/m<jats:sup>2<\/jats:sup> days 1 and 2, with subsequent surgical resection. <\/jats:p><jats:p> Results: Administered dose-intensities were docetaxel 85 mg\/m<jats:sup>2<\/jats:sup>\/3 weeks (range, 53 to 96) and cisplatin 95 mg\/m<jats:sup>2<\/jats:sup>\/3 weeks (range, 0 to 104). The 265 cycles were well tolerated, and the overall response rate was 66% (95% confidence interval [CI], 55% to 75%). Seventy-five patients underwent tumor resection with positive resection margin and involvement of the uppermost mediastinal lymph node in 16% and 35% of patients, respectively (perioperative mortality, 3%; morbidity, 17%). Pathologic complete response occurred in 19% of patients with tumor resection. In patients with tumor resection, downstaging to N0\u20131 at surgery was prognostic and significantly prolonged event-free survival (EFS) and overall survival (OS; P = .0001). At median follow-up of 32 months, the median EFS and OS were 14.8 months (range, 2.4 to 53.4) and 33 months (range, 2.4 to 53.4), respectively. Local relapse occurred in 27% of patients with tumor resection, with distant metastases in 37%. Multivariate analyses identified mediastinal clearance (hazard ratio, 0.22; P = .0003) and complete resection (hazard ratio, 0.26; P = .0006) as strongly prognostic for increased survival. <\/jats:p><jats:p> Conclusion: Neoadjuvant docetaxel-cisplatin is effective and tolerable in stage IIIA pN2 NSCLC. Resection is recommended only for patients with mediastinal downstaging after chemotherapy. <\/jats:p>","DOI":"10.1200\/jco.2003.11.040","type":"journal-article","created":{"date-parts":[[2003,4,29]],"date-time":"2003-04-29T20:58:41Z","timestamp":1051649921000},"page":"1752-1759","source":"Crossref","is-referenced-by-count":352,"title":["Mediastinal Lymph Node Clearance After Docetaxel-Cisplatin Neoadjuvant Chemotherapy Is Prognostic of Survival in Patients With Stage IIIA pN2 Non\u2013Small-Cell Lung Cancer: A Multicenter Phase II Trial"],"prefix":"10.1200","volume":"21","author":[{"given":"Daniel C.","family":"Betticher","sequence":"first","affiliation":[{"name":"From the Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Fang","family":"Hsu Schmitz","sequence":"additional","affiliation":[{"name":"From the Swiss Group for Clinical Cancer Research (SAKK), Bern, 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