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

Yunseon Choi, Ik Jae Lee, Chang Young Lee, Jae Ho Cho, Won Hoon Choi, Hong In Yoon, Yun Han Lee, Chang Geol Lee, Ki Chang Keum, Kyung Young Chung, Seok Jin Haam, Hyo Chae Paik, Kang Kyoo Lee, Sun Rock Moon, Jong Young Lee, Kyung Ran Park, Young Suk Kim

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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.

Original languageEnglish
Pages (from-to)75-82
Number of pages8
JournalRadiation Oncology Journal
Volume33
Issue number2
DOIs
Publication statusPublished - 2015 Jun 1

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging

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    Choi, Y., Lee, I. J., Lee, C. Y., Cho, J. H., Choi, W. H., Yoon, H. I., Lee, Y. H., Lee, C. G., Keum, K. C., Chung, K. Y., Haam, S. J., Paik, H. C., Lee, K. K., Moon, S. R., Lee, J. Y., Park, K. R., & Kim, Y. S. (2015). Multi-institutional analysis of T3 subtypes and adjuvant radiotherapy effects in resected T3N0 non-small cell lung cancer patients. Radiation Oncology Journal, 33(2), 75-82. https://doi.org/10.3857/roj.2015.33.2.75