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World Journal of Surgery
Published in: World Journal of Surgery 11/2013

01-11-2013

Outcome of Surgical Resection as a First Line Therapy in T3 Non-small Cell Lung Cancer Patients

Authors: Tomoyoshi Takenaka, Masakazu Katsura, Yasunori Shikada, Sadanori Takeo

Published in: World Journal of Surgery | Issue 11/2013

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Abstract

Background

The T3 category of the 7th Edition of the TNM classification of non-small cell lung cancer (NSCLC) has added two factors that do not appear in the 6th Edition, large tumor size (>7 cm) and pulmonary metastasis of the same lobe. These factors are considered to have different biological and clinical features. In the present study we assessed the outcome of surgical resection as a first line therapy for T3 NSCLC.

Methods

A total of 145 patients who were diagnosed according to the TNM 7th Edition with pathologic T3 NSCLC received surgical resection in our institution as a first line treatment. The outcomes of their treatment were analyzed.

Results

The 5-year survival rate was 46.9 %. On the basis of the 6th TNM Edition, the 5-year survival rate was 63.1 % for patients diagnosed with T2 disease (large tumor size), 44.3 % for patients diagnosed with T3 disease, and 33.1 % for patients diagnosed with T4 disease (pulmonary metastasis of the same lobe). There were no significant correlations between these categories and overall survival (OS). Nevertheless, 6th Edition T factors were found to be significantly correlated with lymph node status (p < 0.01). The univariate analyses showed that age, lymph node metastasis, and curative resection had significant effects on OS. In addition, the multivariate analysis identified age and N factor as independent prognostic factors in this cohort.

Conclusions

Indications for surgical resection as a first line therapy in T3 NSCLC should be based on N factors and patient age. Lymph node metastasis, especially N2 disease, was increasingly frequent in patients with 6th Edition T classifications.
Literature
1.
Ferlay J, Shin HR, Bray F et al (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 127:2893–2917PubMedCrossRef
2.
Goldstraw P, Crowley J, Chansky K et al (2007) International Association for the Study of Lung Cancer International Staging Committee; participating institutions. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (7th) Edition of the TNM classification of malignant tumours. J Thorac Oncol 2:706–714PubMedCrossRef
3.
Ruffini E, Filosso PL, Bruna MC et al (2009) Recommended changes for T and N descriptors proposed by the International Association for the Study of Lung Cancer—Lung CancerStaging Project: a validation study from a single-centre experience. Eur J Cardiothorac Surg 36:1037–1044PubMedCrossRef
4.
Fukui T, Mori S, Hatooka S et al (2008) Prognostic evaluation based on a new TNM staging system proposed by the International Association for the Study of Lung Cancer for resected non-small cell lung cancers. J Thorac Cardiovasc Surg 136:1343–1348PubMedCrossRef
5.
Mountain CF (1997) Revisions in the International System for Staging lung Cancer. Chest 111:1710–1717PubMedCrossRef
6.
World Health Organization (1999) Histological typing of lung and pleural tumors, 3rd edn. Springer, Geneva
7.
Yoshino I, Nakanishi R, Osaki T et al (1997) Postoperative prognosis in patients with non-small cell lung cancer with synchronous ipsilateral intrapulmonary metastasis. Ann Thorac Surg 64:809–813PubMedCrossRef
8.
Kameyama K, Huang CL, Liu D et al (2002) Problems related to TNM staging: patients with stage III non-small cell lung cancer. J Thorac Cardiovasc Surg 124:503–510PubMedCrossRef
9.
Okada M, Tsubota N, Yoshimura M et al (1999) Evaluation of TMN classification for lung carcinoma with ipsilateral intrapulmonary metastasis. Ann Thorac Surg 68:326–330PubMedCrossRef
10.
Okumura T, Asamura H, Suzuki K et al (2001) Intrapulmonary metastasis of non-small cell lung cancer: a prognostic assessment. J Thorac Cardiovasc Surg 122:24–28PubMedCrossRef
11.
Oliaro A, Filosso PL, Cavallo A et al (2008) The significance of intrapulmonary metastasis in non-small cell lung cancer: upstaging or downstaging? A re-appraisal for the next TNM staging system. Eur J Cardiothorac Surg 34:438–443PubMedCrossRef
12.
Aokage K, Ishii G, Nagai K et al (2007) Intrapulmonary metastasis in resected pathologic stage IIIB non-small cell lung cancer: possible contribution of aerogenous metastasis to the favorable outcome. J Thorac Cardiovasc Surg 134:386–391PubMedCrossRef
13.
Daly BD, Ebright MI, Walkey AJ et al (2011) Impact of neoadjuvant chemoradiotherapy followed by surgical resection on node-negative T3 and T4 non-small cell lung cancer. J Thorac Cardiovasc Surg 141:1392–1397PubMedCrossRef
14.
Lococo F, Cesario A, Margaritora S et al (2012) Induction therapy followed by surgery for T3-T4/N0 non-small cell lung cancer: long-term results. Ann Thorac Surg 93:1633–1640PubMedCrossRef
15.
Arriagada R, Auperin A, Burdett S, NSCLC Meta-analyses Collaborative Group et al (2010) Adjuvant chemotherapy, with or without postoperative radiotherapy, in operable non-small-cell lung cancer: two meta-analyses of individual patient data. Lancet 375:1267–1277PubMedCrossRef
16.
Arriagada R, Dunant A, Pignon JP et al (2010) Long-term results of the international adjuvant lung cancer trial evaluating adjuvant cisplatin-based chemotherapy in resected lung cancer. J Clin Oncol 28:35–42PubMedCrossRef
17.
Albain KS, Swann RS, Rusch VW et al (2009) Radiotherapy plus chemotherapy with or without surgical resection for stage III non-small-cell lung cancer: a phase III randomised controlled trial. Lancet 374:379–386PubMedCrossRef
18.
Yoshino I, Yoshida S, Miyaoka E, Japanese Joint Committee of Lung Cancer Registration et al (2012) Surgical outcome of stage IIIA-cN2/pN2 non-small-cell lung cancer patients in Japanese lung cancer registry study in 2004. J Thorac Oncol 7:850–855PubMedCrossRef
19.
Horinouchi H, Sekine I, Sumi M et al (2013) Long-term results of concurrent chemoradiotherapy using cisplatin and vinorelbine for stage III non-small-cell lung cancer. Cancer Sci 104:93–97PubMedCrossRef
Metadata
Title
Outcome of Surgical Resection as a First Line Therapy in T3 Non-small Cell Lung Cancer Patients
Authors
Tomoyoshi Takenaka
Masakazu Katsura
Yasunori Shikada
Sadanori Takeo
Publication date
01-11-2013
Publisher
Springer US
Published in
World Journal of Surgery / Issue 11/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-013-2174-7

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