Although surgical resection offers the best chance for long-term survival f
or patients with non-small cell lung cancer (NSCLC), the limited number of
resectable patients and the presence of micrometastatic disease is limiting
the effectiveness of this modality as sole treatment. Results of randomize
d trials demonstrated a survival benefit for preoperative (neoadjuvant) cis
platin-based chemotherapy in patients with stage IIIA NSCLC compared to sur
gery alone. In stage I + II NSCLC preoperative chemotherapy, although still
experimental, clearly offers encouraging results. However, there is no evi
dence of its superiority over adjuvant chemotherapy. Moreover, for adjuvant
therapy a benefit has not been established yet. Possibly current ongoing o
r recently finished trials may change the recommendations on adjuvant or ne
oadjuvant therapy for completely resected or resectable early disease in th
e future. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.