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[Perioperative chemotherapy of stage III N2 non-small cell lung cancer.].

Patients with stage III N2 non-small cell lung cancer (NSCLC) are more than one third of all NSCLC patients. The 5-year survival rate of them is approximately 15%. From therapeutic views, stage IIIA N2 of 97 International Lung Cancer Staging System is an obvious hetero-combination, which includes mediastinal lymph node metastasis based on microscope after postoperative examination and N2 of single station or N2 of multiple stations based on computerized tomographic scanning and N2 of mediastinal lymph node mixed together. The different status of stage N2 lead to different prognosis. Andre et al [1] reported the results of continuous surgery in 702 patients with NSCLC, which showed that N2 of single station based on microscope, 5-year survival rate was 34% (244 cases), N2 of multiple stations based on microscope, 5-year survival rate was 11% (788 cases), N2 of single station based on radiograph, 5-year survival rate was 8% (118 cases), and N2 of multiple stations based on radiograph, 5-year survival rate was only 3% (122 cases). Although surgery has achieved some effects on patients with stage III N2 because of promotion in complete resection rate, the postoperative 5-year survival rate is still not satisfactory. NSCLC patients who have been identified as stage IIIA N2 by clinical staging should take surgery-predominant comprehensive therapies, including neoadjuvant chemotherapy, neoadjuvant concurrent chemoradiation therapy and postoperative chemotherapy.