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Multi-institutional analysis of T3 subtypes and adjuvant radiotherapy effects in resected T3N0 non-small cell lung cancer patients.

Choi Y, Lee IJ, Lee CY, Cho JH, Choi WH, Yoon HI, Lee YH, Lee CG, Keum KC, Chung KY, Haam SJ, Paik HC, Lee KK, Moon SR, Lee JY, Park KR, Kim YS - Radiat Oncol J (2015)

Bottom Line: In postoperative T3N0M0 patients, the tumor size was a significant prognostic factor for survival (OS, p = 0.035 and DFS, p = 0.035, respectively).However, adjuvant radiotherapy did not cause any improvement in survival (OS, p = 0.518 and DFS, p = 0.463, respectively).Adjuvant radiotherapy is not effective in improving survival outcome in resected T3N0 NSCLC.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ; Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

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.

No MeSH data available.


Related in: MedlinePlus

Overall survival (OS) and disease-free survival (DFS) among the 102 patients. The median OS was 55.3 months and the median DFS was 51.2 months.
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Figure 2: Overall survival (OS) and disease-free survival (DFS) among the 102 patients. The median OS was 55.3 months and the median DFS was 51.2 months.

Mentions: The median OS was 55.3 months and the median DFS was 51.2 months (Fig. 2). The actuarial 4-year loco-regional relapse-free survival was 49.9%, and the 4-year distant metastasis-free survival was 53%. The univariate analysis showed that OS (p = 0.008) and DFS (p = 0.004) were significantly lower in tumors that measured 5 cm and above (Table 3). Patients with endobronchial tumors located <2 cm distal to the carina showed higher survival rate than other T3 subtypes in the univariate analysis (OS, p = 0.003 and DFS, p = 0.006, respectively). Also, the patients with pleural invasion showed lower survival than other T3 subtypes in the univariate analysis (OS, p = 0.023 and DFS, p = 0.049, respectively). On multivariate analysis, the OS and DFS were significantly lower in tumors that measured ≥5 cm than in tumors <5 cm (p = 0.035 and p = 0.035, respectively) (Table 3). The location of endobronchial tumors <2 cm distal to the carina was an independent prognostic factor for OS and DFS (p = 0.018 and p = 0.016, respectively) (Table 3). The survival rate according to operation type and extent of resection was analyzed, and no statistically significant difference was noted in survival (Tables 3). The OS showed no significant difference between the pneumonectomy group (n = 30) and the lobectomy (n = 64) group (p = 0.417 vs. p = 0.601, respectively). Wedge resection was performed only on 3 patients and showed high treatment failure rates (66.7%). The patients who underwent wedge resection showed a lower survival rate (4-year OS, 33.3% and 4-year DFS, 33.3%, respectively) than the patients treated with other types of curative resection. These patients underwent wedge resections owing to tuberculosis (n = 2, 2.0%) or emphysema (n = 1, 1.0%) or bronchiectasis (n = 1, 1.0%). No significant difference was found in OS and DFS between patients treated with or without adjuvant chemotherapy (p = 0.440 and p = 0.619, respectively).


Multi-institutional analysis of T3 subtypes and adjuvant radiotherapy effects in resected T3N0 non-small cell lung cancer patients.

Choi Y, Lee IJ, Lee CY, Cho JH, Choi WH, Yoon HI, Lee YH, Lee CG, Keum KC, Chung KY, Haam SJ, Paik HC, Lee KK, Moon SR, Lee JY, Park KR, Kim YS - Radiat Oncol J (2015)

Overall survival (OS) and disease-free survival (DFS) among the 102 patients. The median OS was 55.3 months and the median DFS was 51.2 months.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493431&req=5

Figure 2: Overall survival (OS) and disease-free survival (DFS) among the 102 patients. The median OS was 55.3 months and the median DFS was 51.2 months.
Mentions: The median OS was 55.3 months and the median DFS was 51.2 months (Fig. 2). The actuarial 4-year loco-regional relapse-free survival was 49.9%, and the 4-year distant metastasis-free survival was 53%. The univariate analysis showed that OS (p = 0.008) and DFS (p = 0.004) were significantly lower in tumors that measured 5 cm and above (Table 3). Patients with endobronchial tumors located <2 cm distal to the carina showed higher survival rate than other T3 subtypes in the univariate analysis (OS, p = 0.003 and DFS, p = 0.006, respectively). Also, the patients with pleural invasion showed lower survival than other T3 subtypes in the univariate analysis (OS, p = 0.023 and DFS, p = 0.049, respectively). On multivariate analysis, the OS and DFS were significantly lower in tumors that measured ≥5 cm than in tumors <5 cm (p = 0.035 and p = 0.035, respectively) (Table 3). The location of endobronchial tumors <2 cm distal to the carina was an independent prognostic factor for OS and DFS (p = 0.018 and p = 0.016, respectively) (Table 3). The survival rate according to operation type and extent of resection was analyzed, and no statistically significant difference was noted in survival (Tables 3). The OS showed no significant difference between the pneumonectomy group (n = 30) and the lobectomy (n = 64) group (p = 0.417 vs. p = 0.601, respectively). Wedge resection was performed only on 3 patients and showed high treatment failure rates (66.7%). The patients who underwent wedge resection showed a lower survival rate (4-year OS, 33.3% and 4-year DFS, 33.3%, respectively) than the patients treated with other types of curative resection. These patients underwent wedge resections owing to tuberculosis (n = 2, 2.0%) or emphysema (n = 1, 1.0%) or bronchiectasis (n = 1, 1.0%). No significant difference was found in OS and DFS between patients treated with or without adjuvant chemotherapy (p = 0.440 and p = 0.619, respectively).

Bottom Line: In postoperative T3N0M0 patients, the tumor size was a significant prognostic factor for survival (OS, p = 0.035 and DFS, p = 0.035, respectively).However, adjuvant radiotherapy did not cause any improvement in survival (OS, p = 0.518 and DFS, p = 0.463, respectively).Adjuvant radiotherapy is not effective in improving survival outcome in resected T3N0 NSCLC.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ; Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

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.

No MeSH data available.


Related in: MedlinePlus