| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2007;83:397-400
© 2007 The Society of Thoracic Surgeons
Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Weill Medical College of Cornell University, New York
Accepted for publication August 10, 2006.
* Address correspondence to Dr Altorki, Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Suite M404, New York Presbyterian Hospital–Weill Medical College of Cornell University, 525 E 68th St, New York, NY 10021. (Email: nkaltork{at}med.cornell.edu).
BACKGROUND: The current international staging system for lung cancer designates intralobar satellites as T4 disease. In this study, we sought to determine the impact of multifocal, intralobar non-small cell lung cancer (NSCLC) on patient survival and its potential relevance to stage designation.
METHODS: We conducted a retrospective review of our thoracic surgical cancer registry from 1990 to 2005. Included were 53 patients with a resected lung cancer containing intralobar satellites detected preoperatively (n = 8) or in the resected specimen (n = 45). Patients with multicentric bronchioloalveolar cancer were excluded. All patients had an anatomic resection with mediastinal lymph node dissection. Median follow-up for the entire group was 31 months. Survival was calculated by the Kaplan-Meier method. A Cox proportional hazards regression model was performed to examine simultaneously the effects on overall survival of age, gender, nodal disease, number of satellite lesions, lymphatic invasion, and T status.
RESULTS: The median age of the 53 patients with multifocal, intralobar (T4) disease was 68 years and 31 were women. Ten patients had more than one satellite lesion. Overall 5-year survival was 47.6% (95% confidence interval [CI], 27.36% to 65.30%) for all patients with resected intralobar satellites. Patients without nodal metastases had a 5-year survival of 58.4% (95% CI, 28.76% to 79.30%). The Cox regression identified female gender (adjusted hazard ratio [HR], 0.31; 95% CI, 0.10 to 0.96; p < 0.04) as a significant prognostic variable but only a trend towards significance for nodal status (adjusted HR, 2.3; 95% CI, .83 to 6.26; p < 0.11).
CONCLUSIONS: Patients with intralobar multifocal NSCLC detected in the resected specimen have a more favorable prognosis after surgical resection than might be predicted by their stage T4 designation. Five-year survival rates, especially in T4N0 patients, more closely approximate those with stages IB or II NSCLC.
Related Article
Ann. Thorac. Surg. 2007 83: 400-401.
This article has been cited by other articles:
|
|
 |
|
  F. Farjah, D. E. Wood, T. K. Varghese Jr, R. G. Symons, and D. R. Flum Trends in the operative management and outcomes of T4 lung cancer. Ann. Thorac. Surg., August 1, 2008; 86(2): 368 - 374. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. Lee, C. Y. Lee, D. J. Kim, K. Y. Chung, and I. K. Park Non-small cell lung cancer with ipsilateral pulmonary metastases: prognosis analysis and staging assessment Eur. J. Cardiothorac. Surg., March 1, 2008; 33(3): 480 - 484. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Trousse, X. B. D'Journo, J.-P. Avaro, C. Doddoli, R. Giudicelli, P. A. Fuentes, and P. A. Thomas Multifocal T4 non-small cell lung cancer: a subset with improved prognosis Eur. J. Cardiothorac. Surg., January 1, 2008; 33(1): 99 - 103. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Deslauriers Invited commentary Ann. Thorac. Surg., February 1, 2007; 83(2): 400 - 401. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
