T3非小细胞肺癌患者的手术完全切除和长期生存率：IASLC研究

SCI

21 September 2023

Completeness of Resection and Long-term Survival of Patients Undergoing Resection for Pathological T3 Non-small-cell Lung Cancer: An International Association for the Study of Lung Cancer Analysis

(Journal of Thoracic Oncology, IF: 20.4)

Paula Ugalde Figueroa, MD, Edouard Marques, MD, Vanessa J. Cilento, MS, Dorothy J. Giroux, MS, Katherine K. Nishimura, PhD, MPH, Frank C. Detterbeck, MD, Paul Van Schil, MD, PhD, Pietro Bertoglio, MD, Chi-Fu Jeffrey Yang, MD, Wentao Fang, MD, the Members of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions for the 8th lung cancer TNM edition

CORRESPONDENCE TO: pugaldefigueroa@bwh.harvard.edu

Introduction 简介

Currently, tumors with different histopathological characteristics and oncologic outcomes comprise the T3 category of the 8th edition tumor, node, and metastasis (TNM) classification for lung cancers. To better understand the T3 category, we evaluated completeness of resection and long-term survival in patients undergoing resection for T3 non-small-cell lung cancer (NSCLC).

目前，第8版肺癌肿瘤、淋巴结和转移（TNM）分类的T3类肿瘤包括了具有不同组织病理学特征和肿瘤学结局的肿瘤。为了更好地了解T3分类，我们评估了接受T3非小细胞肺癌（NSCLC）切除手术的患者的切除完整性和长期生存率。

Methods 方法

The International Association for the Study of Lung Cancer 1999-2010 database was queried for patients with pathological T3N0M0 NSCLC who underwent lobectomy or pneumonectomy. The primary outcome examined was overall survival (OS) stratified by T3-descriptors and completeness of resection.

国际肺癌研究协会查询了1999-2010年数据库中接受肺叶切除术或全肺切除术的病理性T3N0M0 NSCLC患者。检查的主要结果是根据T3分期描述和切除的完整性对总生存率（OS）进行分层。

Results 后果

Of 1448 patients with T3N0M0 tumors, 1187 (82.0%) had a single descriptor defining them as T3. T3 tumors with chest wall infiltration (CWI) or parietal pleura infiltration (PL3) had the highest rates of incomplete resection (9.8% and 8.4%, respectively), and those classified as T3 by size only had the lowest rate of incomplete resection (2.9%). Individual T3 descriptors were associated with significant differences in OS (p=0.005). When tumors with similar survival and complete resection rates were grouped, patients with T3 tumors characterized by size or the presence of a separate nodule (SN) in the same lobe had better 5-year OS than patients with tumors characterized by PL3 or CWI (Size/SN 60% vs CWI/PL3 53%, p=0.017) independent of completeness of resection.

在1448例T3N0M0肿瘤患者中，1187例（82.0%）有一个单一的描述依据将其定义为T3。胸壁浸润（CWI）或胸顶胸膜浸润（PL3）的T3肿瘤不完全切除率最高（分别为9.8%和8.4%），而仅按大小分类为T3的肿瘤不完全切除率最低（2.9%）。单个T3描述依据与OS的显著差异相关（p=0.005）。当将具有相似生存率和完全切除率的肿瘤分组时，以大小或在同一叶中存在单独结节（SN）为特征的T3肿瘤患者的5年OS优于以PL3或CWI为特征的肿瘤患者（大小/SN 60%vs CWI/PL3 53%，p=0.017），5年OS与切除的完整性无关。

Conclusions 结论

Significant differences in 5-year OS were associated with size, SN, PL3, or CWI T3-descriptors. Subdividing pathological T3N0M0 tumors according to the presence or absence of CWI or PL3 may increase the prognostic accuracy of tumor staging.

5年OS的显著差异与大小、SN、PL3或CWI 的T3描述依据有关。根据CWI或PL3的存在与否对病理性T3N0M0肿瘤进行细分可以提高肿瘤分期的预后准确性。

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