title: [The stratification of surgically treated T4 (stage IIIb) primary lung cancers; analysis of cases with intrapulmonary metastases in the same lobe as the primary tumors (pm 1) and invading adjacent organs].
abstract: OBJECTIVE
  The purpose of this article was to investigate the validity of T4 classification of primary non-small cell lung cancer.
  
  
  METHODS
  We retrospectively reviewed the clinical outcome of cases with pm 1 (n = 65) and T4 tumors invading adjacent organs (n = 36).
  
  
  RESULTS
  When the pm 1 tumors were excised completely (n = 57), the prognosis of these cases was affected by the pN factor (5-year survival rate: pN 0-1; 70.1%, pN 2-3; 7.7%, p = 0.0002) and comparable to that of T2 diseases (pN 0-1 cases: p = 0.7315). The patients who underwent complete resection for their pm 1 tumors had a significantly better prognosis than cases with disseminations or malignant pleural effusions which had the same T4 classification (p < 0.0001). The prognosis of the patients who underwent complete resection for the tumors invading adjacent organs (classified under T4) was similar to that of T3 diseases (pN 0-1 cases: p = 0.7116).
  
  
  CONCLUSIONS
  Patients whose lung cancer is classified as T4 comprise 2 subgroups; those whose tumors can be completely resected, and those in whom complete resection is impractical. There is a significant difference in the management and the prognosis between these 2 groups although they share the same T4 classification.
authors.affiliation: Department of Thoracic Surgery, Hyogo Medical Center for Adults, Akashi, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Harada
authors.forename: W
authors.initials: W
authors.lastname: Nishio
authors.forename: T
authors.initials: T
authors.lastname: Sakamoto
authors.forename: K
authors.initials: K
authors.lastname: Uchino
authors.forename: H
authors.initials: H
authors.lastname: Matsuoka
authors.forename: N
authors.initials: N
authors.lastname: Tsubota
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000145:classification* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000145:classification* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000401:mortality; D011013:Pneumonectomy / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate