Skip to main content

Advertisement

Log in

Chest wall/parietal pleural invasions worsen prognosis in T4 non-small cell lung cancer patients after resection

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objectives

Appropriate selection for surgery is particularly important in T4 non-small cell lung cancer patients. In clinical settings, patients those who are positive for T4 criteria occasionally are also positive for T3 factors which are independently defined from original T4 or even have multiple T4 factors. Significance of these factors on prognosis is still unknown.

Methods

We retrospectively reviewed clinicopathorogical data of 113 patients with T4 non-small cell lung cancer those who underwent surgery between 1990 and 2015 in Tohoku University Hospital. Significance on prognosis of single or multiple T4 factors and with or without independent T3 factors were statistically analyzed.

Results

No significant difference was seen in the 5-year survival rate between patients with single (35.6%) and multiple (31.4%) T4 factors (P = 0.94), but the rate was significantly lower when patients also had independent T3 factors (19.6%) compared with when they did not (42.5%) (P = 0.011). The 5-year survival rate was particularly lower among patients with invasion of the chest wall or parietal pleura (8.1%) than in those without (40.6%) (P = 0.0052).

Conclusions

Invasion of the chest wall or parietal pleura is poor prognostic factors in T4 non-small cell lung cancer patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Watanabe S, Asamura H, Miyaoka E, Okumura M, Yoshino I, Fujii Y, et al. Results of T4 surgical cases in the Japanese Lung Cancer Registry Study: should mediastinal fat tissue invasion really be included in the T4 category? J Thorac Oncol. 2013;8(6):759–65.

    Article  PubMed  Google Scholar 

  2. Yildizeli B, Dartevelle PG, Fadel E, Mussot S, Chapelier A. Results of primary surgery with T4 non-small cell lung cancer during a 25-year period in a single center: the benefit is worth the risk. Ann Thorac Surg. 2008;86(4):1065–75 (discussion 74–5).

    Article  PubMed  Google Scholar 

  3. Stella F, Dell’Amore A, Caroli G, Dolci G, Cassanelli N, Luciano G, et al. Surgical results and long-term follow-up of T(4)-non-small cell lung cancer invading the left atrium or the intrapericardial base of the pulmonary veins. Interact Cardiovasc Thorac Surg. 2012;14(4):415–9.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wu L, Xu Z, Zhao X, Li J, Zhong L, Pang T, et al. Surgical treatment of lung cancer invading the left atrium or base of the pulmonary vein. World J Surg. 2009;33(3):492–6.

    Article  PubMed  Google Scholar 

  5. Osaki T, Sugio K, Hanagiri T, Takenoyama M, Yamashita T, Sugaya M, et al. Survival and prognostic factors of surgically resected T4 non-small cell lung cancer. Ann Thorac Surg. 2003;75(6):1745–51 (discussion 51).

    Article  PubMed  Google Scholar 

  6. Rice TW, Blackstone EH. Radical resections for T4 lung cancer. Surg Clin North Am. 2002;82(3):573–87.

    Article  PubMed  Google Scholar 

  7. Pitz CC, Brutel de la Riviere A, van Swieten HA, Westermann CJ, Lammers JW, van den Bosch JM. Results of surgical treatment of T4 non-small cell lung cancer. Eur J Cardiothorac Surg. 2003;24(6):1013–8.

    Article  PubMed  Google Scholar 

  8. Riquet M, Grand B, Arame A, Pricopi CF, Foucault C, Dujon A, et al. Lung cancer invading the pericardium: quantum of lymph nodes. Ann Thorac Surg. 2010;90(6):1773–7.

    Article  PubMed  Google Scholar 

  9. Yang HX, Hou X, Lin P, Rong TH, Yang H, Fu JH. Survival and risk factors of surgically treated mediastinal invasion T4 non-small cell lung cancer. Ann Thorac Surg. 2009;88(2):372–8.

    Article  PubMed  Google Scholar 

  10. Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC Lung Cancer Staging Project: proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol. 2016;11(1):39–51.

    Article  PubMed  Google Scholar 

  11. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transpl. 2013;48(3):452–8.

    Article  CAS  Google Scholar 

  12. Ohta M, Hirabayasi H, Shiono H, Minami M, Maeda H, Takano H, et al. Surgical resection for lung cancer with infiltration of the thoracic aorta. J Thorac Cardiovasc Surg. 2005;129(4):804–8.

    Article  PubMed  Google Scholar 

  13. Chambers A, Routledge T, Bille A, Scarci M. Does surgery have a role in T4N0 and T4N1 lung cancer? Interact Cardiovasc Thorac Surg. 2010;11(4):473–9.

    Article  PubMed  Google Scholar 

  14. Dartevelle PG, Mitilian D, Fadel E. Extended surgery for T4 lung cancer: a 30 years’ experience. Gen Thorac Cardiovasc Surg. 2017;65(6):321–8.

    Article  CAS  PubMed  Google Scholar 

  15. Misthos P, Papagiannakis G, Kokotsakis J, Lazopoulos G, Skouteli E, Lioulias A. Surgical management of lung cancer invading the aorta or the superior vena cava. Lung Cancer. 2007;56(2):223–7.

    Article  CAS  PubMed  Google Scholar 

  16. Leong TL, Loveland PM, Gorelik A, Irving L, Steinfort DP. Preoperative staging by EBUS in cN0/N1 lung cancer: systematic review and meta-analysis. J Bronchol Interv Pulmonol 2018. https://doi.org/10.1097/LBR.0000000000000545

    Article  Google Scholar 

  17. DiPerna CA, Wood DE. Surgical management of T3 and T4 lung cancer. Clin Cancer Res. 2005;11(13 Pt 2):5038s-44 s.

    Google Scholar 

  18. Lococo F, Cesario A, Margaritora S, Dall’Armi V, Nachira D, Cusumano G, et al. Induction therapy followed by surgery for T3-T4/N0 non-small cell lung cancer: long-term results. Ann Thorac Surg. 2012;93(5):1633–40.

    Article  PubMed  Google Scholar 

  19. Grunenwald DH, Andre F, Le Pechoux C, Girard P, Lamer C, Laplanche A, et al. Benefit of surgery after chemoradiotherapy in stage IIIB (T4 and/or N3) non-small cell lung cancer. J Thorac Cardiovasc Surg. 2001;122(4):796–802.

    Article  CAS  PubMed  Google Scholar 

  20. Roberts JR, Eustis C, Devore R, Carbone D, Choy H, Johnson D. Induction chemotherapy increases perioperative complications in patients undergoing resection for non-small cell lung cancer. Ann Thorac Surg. 2001;72(3):885–8.

    Article  CAS  PubMed  Google Scholar 

  21. Matsubara Y, Takeda S, Mashimo T. Risk stratification for lung cancer surgery: impact of induction therapy and extended resection. Chest. 2005;128(5):3519–25.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Akira Sakurada.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yabuki, H., Sakurada, A., Eba, S. et al. Chest wall/parietal pleural invasions worsen prognosis in T4 non-small cell lung cancer patients after resection. Gen Thorac Cardiovasc Surg 67, 788–793 (2019). https://doi.org/10.1007/s11748-019-01093-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-019-01093-8

Keywords

Navigation