title: Evaluation of T factor, surgical method, and prognostic factors in central type lung cancer.
abstract: OBJECTIVE
  We report our experience in the diagnosis and surgical treatment of central type lung cancer (CTLC) and discuss the prognostic significance of clinicopathological factors including the T factor.
  
  
  METHODS
  Subjects were 151 patients with CTLC undergoing surgery from 1984 to 1999. Surgical procedures include lobectomy in 111, pneumonectomy in 35, and segmentectomy in 5. Bronchoplasty was done in 44, including sleeve lobectomy in 33, carinal resection in 8, and bronchoplasty without resection of pulmonary parenchyma in 3. Data on CTLC was compared to that on peripheral lung cancer during the same period.
  
  
  RESULTS
  Compared to peripheral tumors, central lung tumors showed a higher ratio in male gender, pN1 in pN factors, squamous cell carcinoma in histology, and pneumonectomy and bronchoplasty in surgery. No statistical differences were seen between groups in surgical outcome, mean age, distribution pattern in pT factors, and extended surgery. The positive predictive cT factor has improved. No significant difference was seen in 5-year survival based on 8 factors--period, cT factors, tumor histology, bronchoplasty, extended surgery, cellular atypia, additional chemotherapy, and radiotherapy. Five-year survival differed significantly for 12 other factors--pT, cN, and pN factors; surgical method; number of resected organs in extended surgery; curability (complete/incomplete); tumor size; N1 and N2 station metastasis; p factor, and blood vessel and lymphatic invasion. Multivariable analysis indicated only 2 independent prognostic factors--cN and p factor.
  
  
  CONCLUSIONS
  CTLC appears to belong to a subgroup other than peripheral tumors, requiring a more accurate diagnosis of cT factors, particularly in the proximal bronchus, because cT and cN factors are the only 2 used preoperatively.
authors.affiliation: Department of Chest Surgery, Tokyo Medical University Kasumigaura Hospital, 3-20-1 Chuo, Ami-machi, Inashiki, Ibaraki 300-0395, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Saito
authors.forename: Kinya
authors.initials: K
authors.lastname: Furukawa
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Miura
authors.forename: Harubumi
authors.initials: H
authors.lastname: Kato
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011379:Prognosis