Radiat Oncol J.
2015 Jun;33(2):75-82. 10.3857/roj.2015.33.2.75.
Multi-institutional analysis of T3 subtypes and adjuvant radiotherapy effects in resected T3N0 non-small cell lung cancer patients
- Affiliations
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- 1Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ikjae412@yuhs.ac
- 2Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
- 3Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University School of Medicine, Seoul, Korea.
- 4Department of Radiation Oncology, Wonkwang University School of Medicine, Iksan, Korea.
- 5Department of Radiation Oncology, Wonju Severance Christian Hospital, Wonju, Korea.
- 6Department of Radiation Oncology, Ewha Womans University Hospital, Seoul, Korea.
- 7Department of Radiation Oncology, Jeju National University Hospital, Jeju University College of Medicine, Jeju, Korea.
- KMID: 2138876
- DOI: http://doi.org/10.3857/roj.2015.33.2.75
Abstract
- PURPOSE
We evaluated the prognostic significance of T3 subtypes and the role of adjuvant radiotherapy in patients with resected the American Joint Committee on Cancer stage IIB T3N0M0 non-small cell lung cancer (NSCLC).
MATERIALS AND METHODS
T3N0 NSCLC patients who underwent resection from January 1990 to October 2009 (n = 102) were enrolled and categorized into 6 subgroups according to the extent of invasion: parietal pleura chest wall invasion, mediastinal pleural invasion, diaphragm invasion, separated tumor nodules in the same lobe, endobronchial tumor <2 cm distal to the carina, and tumor-associated collapse.
RESULTS
The median overall survival (OS) and disease-free survival (DFS) were 55.3 months and 51.2 months, respectively. In postoperative T3N0M0 patients, the tumor size was a significant prognostic factor for survival (OS, p = 0.035 and DFS, p = 0.035, respectively). Patients with endobronchial tumors within 2 cm of the carina also showed better OS and DFS than those in the other T3 subtypes (p = 0.018 and p = 0.016, respectively). However, adjuvant radiotherapy did not cause any improvement in survival (OS, p = 0.518 and DFS, p = 0.463, respectively). Only patients with mediastinal pleural invasion (n = 25) demonstrated improved OS and DFS after adjuvant radiotherapy (n = 18) (p = 0.012 and p = 0.040, respectively).
CONCLUSION
The T3N0 NSCLC subtype that showed the most favorable prognosis is the one with endobronchial tumors within 2 cm of the carina. Adjuvant radiotherapy is not effective in improving survival outcome in resected T3N0 NSCLC.
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