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KMID : 1038620150330020075
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Radiation Oncology Journal
2015 Volume.33 No. 2 p.75 ~ p.82
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Multi-institutional analysis of T3 subtypes and adjuvant radiotherapy effects in resected T3N0 non-small cell lung cancer patients
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Choi Yun-Seon
Lee Ik-Jae
Lee Chang-Young
Cho Jae-Ho
Choi Won-Hoon
Yoon Hong-In
Lee Yun-Han
Lee Chang-Geol
Keum Ki-Chang
Chung Kyung-Young
Seok Jin-Haam
Paik Hyo-Chae
Lee Kang-Kyoo
Moon Sun-Rock
Lee Jong-Young
Park Kyung-Ran
Kim Young-Suk
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Abstract
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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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KEYWORD
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Non-small cell lung cancer, Adjuvant radiotherapy, Prognostic factor
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