Non-small cell lung cancer: Perioperative treatments

The objectives of perioperative treatments in non-small cell lung cancer (NSCLC) are to reduce the risk of recurrence, by the early destruction of micrometastases. Data from the literature have been used to precise their indications and modalities. However, for each patient, the decision of a perioperative treatment must result from a multidisciplinary discussion. Perioperative chemotherapy is indicated in stage II or III NSCLC. Adjuvant chemotherapy, which has a highest best level of evidence, is standard, with a 5% survival benefit at 5 years. Preoperative chemotherapy is on option. Postoperative mediastinal radiotherapy has to be discussed in pN2 disease. Ongoing studies in the perioperative setting evaluate the role of targeted agents, and the interest of personalized strategies based on biological markers.