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Results of treatment and lessons learned from pathologically staged T4 non‐small cell lung cancer
Author(s) -
MacChiarini Paolo,
Silvano Giovanni,
Janni Alberto,
Mussi Alfredo,
Chella Antonio,
Angeletti Carlo A.
Publication year - 1991
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930470402
Subject(s) - medicine , lung cancer , radiation therapy , univariate analysis , multivariate analysis , surgery , systemic therapy , creatinine , cancer , gastroenterology , urology , breast cancer
Abstract Depending on the local extension of primary non‐small cell lung cancer (NSCLC) and invaded T4 structure(s), 49 patients underwent complete (CR, n = 14) or palliative (PR, n = 13) resection or exploratory thoracotomy (ET, n = 22) between January 1982 and June 1988. Thoracic radiotherapy (TR) was given to all patients receiving PR (median dose, 43 Gy) and ET (median dose, 53 Gy). With a median follow‐up of 44 months, overall 2‐ and 5‐year survival was 25 and 5%, respectively. Patients undergoing ET plus TR had a significantly worse survival than those treated by CR ( P = 0.041) and PR plus TR ( P = 0.046). Only completely resected patients became long‐term survivors (5‐year survival, 29%) and significant predictors of their survival were previous weight loss, hemoglobin, and creatinine level, in univariate analysis, and previous weight loss in multivariate analysis. The site of initial treamtent failure was mainly local for PR plus TR (85%) and systemic for CR (71 %) and ET plus TR (86%). Presented results suggest that surgery might play a role for selected patients with T4 NSCLC, but advances in systemic and local therapy are necessary.