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

Radiation Oncology Journal
2015년 33권 2호 p.75 ~ p.82
최윤선 ( Choi Yun-Seon ) - Inje University College of Medicine Inje University Busan Paik Hospital Department of Radiation Oncology

이익재 ( Lee Ik-Jae ) - Yonsei University College of Medicine Department of Radiation Oncology
이창영 ( Lee Chang-Young ) - Yonsei University College of Medicine Severance Hospital Department of Thoracic and Cardiovascular Surgery
조재호 ( Cho Jae-Ho ) - Yonsei University College of Medicine Department of Radiation Oncology
최원훈 ( Choi Won-Hoon ) - Yonsei University College of Medicine Department of Radiation Oncology
 ( Yoon Hong-In ) - Yonsei University College of Medicine Department of Radiation Oncology
이윤한 ( Lee Yun-Han ) - Yonsei University College of Medicine Department of Radiation Oncology
이창걸 ( Lee Chang-Geol ) - Yonsei University College of Medicine Department of Radiation Oncology
금기창 ( Keum Ki-Chang ) - Yonsei University College of Medicine Department of Radiation Oncology
정경영 ( Chung Kyung-Young ) - Yonsei University College of Medicine Department of Thoracic and Cardiovascular Surgery
석진함 ( Seok Jin-Haam ) - Yonsei University College of Medicine Severance Hospital Department of Thoracic and Cardiovascular Surgery
백효채 ( Paik Hyo-Chae ) - Yonsei University College of Medicine Department of Thoracic and Cardiovascular Surgery
이강규 ( Lee Kang-Kyoo ) - Wonkwang University School of Medicine Department of Radiation Oncology
문성록 ( Moon Sun-Rock ) - Wonkwang University School of Medicine Department of Radiation Oncology
이종영 ( Lee Jong-Young ) - Wonju Severance Christian Hospital Department of Radiation Oncology
박경란 ( Park Kyung-Ran ) - Ewha Womans University Hospital Department of Radiation Oncology
김영석 ( Kim Young-Suk ) - Jeju National University Hospital Department of Radiation Oncology

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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