title: Multi-institutional analysis of T3 subtypes and adjuvant radiotherapy effects in resected T3N0 non-small cell lung cancer patients.
abstract: OBJECTIVE
  We evaluated the prognostic significance of T3 subtypes and the role of adjuvant radiotherapy in patients with resected the American Joint Committee on Cancer stage IIB T3N0M0 non-small cell lung cancer (NSCLC).
  
  
  METHODS
  T3N0 NSCLC patients who underwent resection from January 1990 to October 2009 (n = 102) were enrolled and categorized into 6 subgroups according to the extent of invasion: parietal pleura chest wall invasion, mediastinal pleural invasion, diaphragm invasion, separated tumor nodules in the same lobe, endobronchial tumor <2 cm distal to the carina, and tumor-associated collapse.
  
  
  RESULTS
  The median overall survival (OS) and disease-free survival (DFS) were 55.3 months and 51.2 months, respectively. In postoperative T3N0M0 patients, the tumor size was a significant prognostic factor for survival (OS, p = 0.035 and DFS, p = 0.035, respectively). Patients with endobronchial tumors within 2 cm of the carina also showed better OS and DFS than those in the other T3 subtypes (p = 0.018 and p = 0.016, respectively). However, adjuvant radiotherapy did not cause any improvement in survival (OS, p = 0.518 and DFS, p = 0.463, respectively). Only patients with mediastinal pleural invasion (n = 25) demonstrated improved OS and DFS after adjuvant radiotherapy (n = 18) (p = 0.012 and p = 0.040, respectively).
  
  
  CONCLUSIONS
  The T3N0 NSCLC subtype that showed the most favorable prognosis is the one with endobronchial tumors within 2 cm of the carina. Adjuvant radiotherapy is not effective in improving survival outcome in resected T3N0 NSCLC.
authors.affiliation: Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ; Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Yunseon
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ik Jae
authors.initials: IJ
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University School of Medicine, Seoul, Korea.
authors.forename: Chang Young
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Cho
authors.affiliation: Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Won Hoon
authors.initials: WH
authors.lastname: Choi
authors.affiliation: Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hong In
authors.initials: HI
authors.lastname: Yoon
authors.affiliation: Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yun-Han
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chang Geol
authors.initials: CG
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ki Chang
authors.initials: KC
authors.lastname: Keum
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University School of Medicine, Seoul, Korea.
authors.forename: Kyung Young
authors.initials: KY
authors.lastname: Chung
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University School of Medicine, Seoul, Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Haam
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University School of Medicine, Seoul, Korea.
authors.forename: Hyo Chae
authors.initials: HC
authors.lastname: Paik
authors.affiliation: Department of Radiation Oncology, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Kang Kyoo
authors.initials: KK
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Sun Rock
authors.initials: SR
authors.lastname: Moon
authors.affiliation: Department of Radiation Oncology, Wonju Severance Christian Hospital, Wonju, Korea.
authors.forename: Jong-Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Ewha Womans University Hospital, Seoul, Korea.
authors.forename: Kyung-Ran
authors.initials: KR
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, Jeju National University Hospital, Jeju University College of Medicine, Jeju, Korea.
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Kim
keywords: Adjuvant radiotherapy; Non-small cell lung cancer; Prognostic factor