With special thanks to the support of the Lung Cancer Connection and longtime member and friend of GRACE Myrtle Chidester, I am very happy to offer a new video podcast presentation on one of the most controversial and interesting areas of lung cancer management. Stage IIIA NSCLC with N2 mediastinal node involvement generates debates among the experts as well as at local hospital tumor boards everywhere, on a weekly basis. There is a little bit of evidence to support several views of how best to treat such patients, while in fact there is a lot of hoterogeneity within the stage IIIA N2 population. For this reason, we often manage people on a case by case basis, which may well be the optimal strategy after all.
Here is a general summary of the current state of the field. Below is the link to the audio version, the transcript and figures, and the video version at the bottom.
Podcast: Play in new window | Download (29.5MB) | Embed
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Hello Dr. West,
Thank you very much for this clear & succinct presentation. My aunt is a 58 yo otherwise healthy, newly diagnosed pt with Stage 3A,N2. Her RUL tumor is 5.5cm. She has bulky paratracheal & subcarinal lymph nodes. She is resectable, per her excellent CT surgeon, via a RULobectomy
We are leaning towards neoadjuvant chemo/moderate dose RX prior to surgery,
as opposed to chemo/high dose radiation without surgery. Our reasoning is that she is young and otherwise healthy, hopefully decreasing her morbidity from this riskier approach.
I was wondering if the increased “early detriment” from the tri-modality group in the above study was actually from surgical complications or the cancer itself.
Thank you for all that you do,
Shaya
My understanding is that the early survival issues on the surgical arm were related to earlier deaths in the setting of trimodality therapy were from complications of surgery, which were likely escalated from the pre-operative therapy).