Preoperative chemotherapy in non-small cell lung cancer: advantages, disadvantages, level of evidence

The combination of chemotherapy and surgery is a standard of care for non-small cell lung cancer, as shown by the recently published "Standards, Options et Recommandations" (SOR) by the Federation des Centres de Lutte contre le Cancer. This document was approved by the INCa, the SPLF, the Ligue contre le Cancer, the IFCT However, the respective position of chemotherapy and surgery remains debated. Most trials of preoperative chemotherapy were closed when the positive studies of adjuvant chemotherapy were published. Therefore, the trials of preoperative chemotherapy lack strength to conclude on the validity of the concept. Confirmation will come from meta-analyses. Two meta-analyses based on published data have been yet published, and are positive.