TY - JOUR AU - Aksoy, Yunus; Citak, Necati; Obuz, Cigdem; Acikmese, Baris; Pekcolaklar, Atilla; Metin, Muzaffer; Sayar, Adnan TI - Prognostic Factors and Survival in Resected T4 Non-small Cell Lung Cancer: Is There Any Difference in the T4 Subgroups? TT - Prognosefaktoren und Überleben bei reseziertem T4 nicht kleinzelligem Lungenkarzinom: Gibt es einen Unterschied in den T4-Untergruppen? SN - 0044-409X SN - 1438-9592 PY - 2020 JO - Zentralbl Chir JF - Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie LA - DE VL - 146 IS - 03 SP - 335 EP - 343 DA - 2020/08/03 KW - surgical treatment KW - survival KW - prognostic factors KW - T4 non-small cell lung cancer KW - surgical treatment KW - survival KW - prognostic factors AB - Introduction The eighth edition of the TNM classification revised the subgroups of T4 non-small cell lung cancer (NSCLC). This study aimed to compare the T4-NSCLC subgroups that underwent surgical treatment in terms of mortality, morbidity, survival, and prognostic factors based on the new classification.Materials and Methods Between 2000 and 2014, a total of 284 T4-NSCLC patients who underwent lung resection (mediastinal organ invasion, n = 114; ipsilateral different lobe tumors, n = 32; and tumors larger than 7 cm, n = 138) were included in the present study.Results Surgical mortality and morbidity were 5.6% (n = 16) and 23.9% (n = 68), respectively. The 5-year survival rates were 46% for ipsilateral different lobe tumors, 45.4% for tumours larger than 7 cm, and 36.6% for mediastinal organ invasion (28% for patients with heart/atrium invasion, 43.3% for carina invasion, 37.5% for large vessel invasion) (p = 0.223). Age above 65 (p = 0.002, HR = 1.781), pN2 versus pN0/1 (p < 0.0001, HR = 2.564), incomplete resection (p = 0.003, HR = 2.297), and pneumonectomy (p = 0.02, HR = 1.524) were identified as poor prognostic survival factors. According to multivariate analysis, mediastinal lymph node metastasis (p = 0.001) and incomplete resection (p = 0.0026) were the independent negative risk factors for survival.Conclusion According to the results of our study, surgical treatment is a good option in T4-NSCLC patients who have no mediastinal lymph node metastasis and are completely resectable. There is no difference in terms of survival among the T4 subgroups. The eighth edition of the TNM classification has a better prognostic definition than the previous version. PB - Georg Thieme Verlag KG DO - 10.1055/a-1209-3668 UR - http://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-1209-3668 ER -