[The significance of surgical treatment for T4 lung cancer].
A total of 114 pT4 patients underwent pulmonary resection from January 1980 to December 1993 at our hospital. The overall five-year survival rate of the 114 cases was 17%. There was no significance between the five-year survival rate of squamous cell carcinoma and that of adenocarcinoma. Five-year survival rates of 17 patients with N0 disease, 29 patients with N1 disease, 51 patients with N2 disease, 1 patients with N3 disease, and 16 patients with NX disease were 40%, 21%, 21%, 0%, and 0%, respectively. Five-year survival rate of 89 cases with single factor of T4 was 24% and that of 25 cases with more than one factor was 4% (0.05 < P < 0.1). In the patients with only single factor of T4, five-year survival rates of 6 patients with left atrium invasion, 13 patients with major vessel invasion, 9 patients with trachea/carina invasion, and 18 patients with vertebral body, were 50%, 38%, 22%, and 0%, respectively. Furthermore, in 38 pT4 patients with involvement only to single adjacent structure, five-year survival rates were 47% in curative operation (n = 17) and 10% in non-curative operation (n = 21) (P < 0.05). We conclude that surgical treatment for T4 lung cancer should be performed to patients with single structure invasion which is expected to have a curative operation. N0 disease is more favorable than N1 or N2 disease.
Sakurada
A
A
Department of Thoracic Surgery, Tohoku University, Sendai, Japan.
Sagawa
M
M
Usuda
K
K
Kanda
A
A
Aikawa
H
H
Chen
Y
Y
Endo
O
O
Takahashi
H
H
Takahashi
S
S
Sato
M
M
Saito
Y
Y
Fujimura
S
S
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018287:Carcinoma, Large Cell / Q000401:mortality / Q000601:surgery; D018288:Carcinoma, Small Cell / Q000401:mortality / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000401:mortality*; D011379:Prognosis; D015996:Survival Rate