Introduction: Long‐term data on outcomes of operable stage III NSCLC are scarce. Methods: Individual patient data from 368 patients enrolled in one phase III and two phase II trials were pooled and outcomes after applying the eighth (denoted with an asterisk [*]) versus the sixth TNM staging edition were compared. Patients were treated with either preoperative radiotherapy following 3 cycles of induction chemotherapy (trimodal) or neoadjuvant chemotherapy alone (bimodal). Results: With the sixth version, the 5‐ and 10‐year survival rates were 38% and 28% for stage IIIA, respectively, and 36% and 24% for stage IIIB, respectively. Factors associated with improved 5‐year overall survival were younger age, R0 resection, and pathologic complete remission (pCR) (p = 0.043, p < 0.001 and p = 0.009). With the eighth TNM staging version, 162 patients were moved from stage IIIA to IIIB*. The 5‐ and 10‐year survival rates were 41% and 29% for stage IIIA*, respectively, and 35% and 27% for stage IIIB* patients, respectively. There was no difference in the bi‐ versus trimodal group with regard to median overall survival (28 months [95% confidence interval (CI): 21–39 months] and 37 months [95% CI: 24–51 months], p = 0.9) and event‐free survival (12 months [95% CI: 9–15 months] versus 13 months [95% CI: 10–22 months], p = 0.71). Conclusions: We showed favorable 10‐year survival rates of 29% and 27% in stage IIIA* and IIIB*, respectively. Younger age, R0 resection, and pathologic complete response were associated with improved long‐term survival. Outcomes using the sixth versus eighth edition of the TNM classification were similar in operable stage III NSCLC.

中文翻译：

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可手术 III 期非小细胞肺癌的多模式治疗：三项 SAKK 试验长期结果的汇总分析 (SAKK 16/96, 16/00, 16/01)

简介：关于可手术的 III 期 NSCLC 结局的长期数据很少。方法：对参加一项 III 期和两项 II 期试验的 368 名患者的个体患者数据进行汇总，并比较应用第八版（用星号 [*] 表示）与第六版 TNM 分期后的结果。患者在接受 3 个周期的诱导化疗（三模式）或新辅助化疗（双模式）后接受术前放疗。结果：在第六版中，IIIA 期的 5 年和 10 年生存率分别为 38% 和 28%，IIIB 期的分别为 36% 和 24%。与提高 5 年总生存率相关的因素是年龄较小、R0 切除和病理完全缓解 (pCR)（p = 0.043、p < 0.001 和 p = 0.009）。有了第八个 TNM 分期版本，162 名患者从 IIIA 期转移到 IIIB*。IIIA* 期患者的 5 年和 10 年生存率分别为 41% 和 29%，IIIB* 期患者分别为 35% 和 27%。双峰组与三峰组的中位总生存期（28 个月 [95% CI：21-39 个月] 和 37 个月 [95% CI：24-51 个月]）没有差异，p = 0.9) 和无事件生存率（12 个月 [95% CI：9-15 个月] 与 13 个月 [95% CI：10-22 个月]，p = 0.71）。结论：我们在 IIIA* 和 IIIB* 期显示出良好的 10 年生存率，分别为 29% 和 27%。年龄较小、R0 切除和病理完全缓解与改善长期生存相关。使用第六版和第八版 TNM 分类的结果在可手术的 III 期 NSCLC 中相似。