Clinical outcomes of neo-adjuvant therapy followed by surgical re- section in 84 patients with IIIA-N2 non-small cell lung cancer

and survival outcomes of patients were presented and the prognostic factors were analyzed. Results: The 3- and 5-year overall survival (OS) rates were 57.7% and 34.2%, respectively, and the 3- and 5-year disease-free survival (DFS) rates were 37.9% and 30.5%, respectively. No significant differences in OS and DFS were observed between R0 and R1 resections (P=0.118; P=0.369), between groups who received neo-adjuvant chemo-radiotherapy and chemotherapy (P=0.771; P=0.953), between cases with and without clinical response (P=0.865; P=0.862), and among groups of different histological subtypes (P=0.685; P=0.208). However, patients with standard lobectomy or pathological nodal downstaging exhibited better OS (P=0.023 and P=0.024, respectively) and DFS (P=0.036 and P= 0.025, respectively) than those who had extensive resections or persistent N2. Univariate analysis predicted better OS and DFS for both standard lobectomy and pathological nodal donwstaging. In addition, Cox multivariate analysis revealed that only pathological nodal downstaging could be considered as a favorable prognostic factor for DFS, while non-smoking and standard lobectomy are the corresponding variables for OS. Conclusion: Neo-adjuvant therapy with platinum-based doublet is feasible and useful in tumor and pathological nodal downstaging, which potentially improved resectability and survival rates in patients with ⅢA-N2 NSCLC. Performing lobectomy or pathological nodal downstaging following induction therapy improved the patients' survival rate.