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H. Niwa
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P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.01-049 - Surgical Treatment Results of T4 Lung Cancer Invading Mediastinum (ID 387)
09:30 - 09:30 | Author(s): H. Niwa
- Abstract
Background:
Inoperable cases are common in T4 lung cancer patients, and their prognoses are mostly poor. Nevertheless, among those who undergo resection, some can achieve long-term survival. We reviewed the validity of surgical treatment for T4 lung cancer at our department.
Methods:
Fifty-six cases of pathologically confirmed T4 lung cancer resection between January 1989 and December 2013 were selected for this study. Cases of nodules in different lobes of the same lung were ineligible. The relationships among the number of infiltrated organs, pN factor, presence or absence of preoperative treatment, histological effect (Ef), and surgical curative rate and prognosis were assessed using statistical techniques.
Results:
The subjects consisted of 53 males and 3 females with an average age of 62.2 years. Depending on the histological types, they were classified as squamous cell cancer (29 cases), adenocarcinoma (16 cases), adenosquamous cancer (7 cases), large cell cancer (1 case), and other cancers (2 cases). Also, there were 37 single and 19 multiple organ infiltration cases, which were classified by infiltrated organ as 16 in the trachea and tracheal bifurcation, 11 in the vertebral body, 10 in the aorta, 10 in the superior vena cava, 9 in the mediastinum, 6 in the left atrium, 6 in the pulmonary artery, 5 in the esophagus, and 2 in the subclavian artery, including duplicated cases. Preoperative treatment was carried out in 22 cases (chemoradiotherapy, 14; chemotherapy, 8), whose histological effect was Ef0-1 in 13 and Ef2-3 in 9. The surgical curative rate was complete resection in 27 and incomplete resection in 29; complete resection was common in those receiving preoperative treatment. There were no death cases within 30 days after the surgery. In all cases, the five-year survival rate was 21.7% and median survival time (MST) was 16.5 months. The five-year survival rate was 27.5% in single organ infiltration compared with 15.8% in multiple organ infiltration (P = 0.08), 27.5% in n0-1 versus 13.8% in n2-3 (P = 0.30), 36.8% with preoperative treatment in contrast to 11.2% without preoperative treatment (P = 0.06), 9.4% in Ef0-1 as opposed to 76.2% in Ef2-3 (P = 0.05), and 37.7% in complete resection in comparison with 7.8% in incomplete resection (P = 0.003). Long-term survival over 5 years was noted in 7 cases (12.5%), 4 of which involved single organ infiltration, n0-1, preoperative treatment, and Ef2-3.
Conclusion:
Single organ infiltration and n0-1 are good surgical indications for T4 lung cancer, and a favorable prognosis can be expected if preoperative treatment and complete resection are performed.
