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JNCI Journal of the National Cancer Institute 2007 99(6):415-418; doi:10.1093/jnci/djk107
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© The Author 2007. Published by Oxford University Press.

EDITORIALS

Scalpels, Beams, Drugs, and Dreams: Challenges of Stage IIIA-N2 Non–Small-Cell Lung Cancer

David H. Johnson, Valerie W. Rusch, Andrew T. Turrisi

Affiliations of authors: Division of Hematology & Medical Oncology, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (DHJ); Department of Thoracic Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (VWR); Department of Radiation Oncology, Karmanos Cancer Center, Wayne State University, Detroit, MI (ATT)

Correspondence to: David H. Johnson, MD, Division of Hematology & Medical Oncology, Vanderbilt-Ingram Cancer Center, 777 Preston Research Bldg, Vanderbilt University School of Medicine, 2220 Pierce Ave, Nashville, TN 37232 (e-mail: david.johnson@vanderbilt.edu).

The first 150 words of the full text of this article appear below.

Approximately 30% of patients who are newly diagnosed with non–small-cell lung cancers (NSCLCs) have locally advanced disease, i.e., stages IIIA and IIIB in the current staging system (1). Roughly 10% will be classified as stage IIIA-N2 on the basis of metastasis to the ipsilateral mediastinal lymph nodes (2). Furthermore, in a small proportion of patients, metastatic disease will be detected from primary tumor and lymph node specimens obtained during an operative procedure (2). Patients with stage IIIA-N2 NSCLC often have a good prognosis after surgery, but today, many will also be treated with postoperative adjuvant chemotherapy (3,4). In contrast, patients who have bulky mediastinal nodal involvement that is easily detected on a routine chest radiograph have poor prognosis after surgery alone (5). Today, however, N2 disease is often initially suspected when mediastinal node enlargement (i.e., >1.0-cm short-axis diameter) . . . [Full Text of this Article]


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