Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Multi-institutional analysis of T3 subtypes and adjuvant radiotherapy effects in resected T3N0 non-small cell lung cancer patients

  • Choi, Yunseon (Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Ik Jae (Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Chang Young (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University School of Medicine) ;
  • Cho, Jae Ho (Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine) ;
  • Choi, Won Hoon (Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine) ;
  • Yoon, Hong In (Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Yun-Han (Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Chang Geol (Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine) ;
  • Keum, Ki Chang (Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine) ;
  • Chung, Kyung Young (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University School of Medicine) ;
  • Haam, Seok Jin (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University School of Medicine) ;
  • Paik, Hyo Chae (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University School of Medicine) ;
  • Lee, Kang Kyoo (Department of Radiation Oncology, Wonkwang University School of Medicine) ;
  • Moon, Sun Rock (Department of Radiation Oncology, Wonkwang University School of Medicine) ;
  • Lee, Jong-Young (Department of Radiation Oncology, Wonju Severance Christian Hospital) ;
  • Park, Kyung-Ran (Department of Radiation Oncology, Ewha Womans University Hospital) ;
  • Kim, Young Suk (Department of Radiation Oncology, Jeju National University Hospital, Jeju University College of Medicine)
  • Received : 2015.01.26
  • Accepted : 2015.03.20
  • Published : 2015.06.30
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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.

Keywords

References

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