Pathologic complete response after induction therapy—the role of surgery in stage IIIA/B locally advanced non-small cell lung cancer

Pathologic complete response (pCR), defined as the absence of tumor cells in all specimens (ypT0N0) is an important prognostic factor in the management of locally advanced non-small cell lung cancer (NSCLC). In various studies pCR determined a long-term survival (LTS), was associated with lower incidence of local and distant recurrence, as well as resulted in favorable progressive-free survival (PFS) (1). Similar prognostic significance of pCR has been reported in esophageal, rectal, breast and bladder cancer (2-6). Irrespective its prognostic significance, the implication of pCR in daily practice is limited, due to inaccurate non-operative evaluation of the tumor response, wide pCR variability depending on treatment protocol and therefore, unpredictable incidence of pCR (7). In addition, despite the robust association between favorable survival and pCR, the correlation between various clinical and pathological factors has rarely been analyzed (1,8)