Appropriate surgical modalities for stages T2a and T2b in the eighth TNM classification of lung cancer

Fenglong Bie,Jiajun Du,Zhaofei Pang,Shaorui Liu,Wei Dong,Xiao Qu,Xudong Yang,Yufan Yang

doi:10.1038/s41598-017-13495-w

Fenglong Bie, Jiajun Du + Show 6 more

Open Access

https://doi.org/10.1038/s41598-017-13495-w

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Abstract

Patients with tumors of 3 to 5 cm were divided into stages T2a (3 to 4 cm) and T2b (4 to 5 cm) based on the 8th tumor-node-metastasis staging system for lung cancer. The objective of our study was to explore appropriate surgical modalities for the new stages, T2a and T2b. We selected 6,996 node-negative non-small-cell lung cancer patients with tumor sizes of 3 to 5 cm, diagnosed between 2009 and 2013, from the Surveillance, Epidemiology, and End Results (SEER) program. The Pearson {chi }^{2}. statistic test and Kaplan–Meier curve were used to analyze patient data. The prognosis of patients with stage T2a was significantly better than that of patients with stage T2b, both in overall survival (p = 0.018) and lung cancer specific survival (p = 0.001). For patients with stage T2a, lobectomy had a significantly better outcome. For patients with stage T2b, surgical modalities including pneumonectomy, segmental resection and lobectomy, had similar outcomes in terms of survival. Consequently, lobectomy was the most appropriate surgical treatment modality for new stage T2a patients, whereas, for new T2b patients, treatment outcome did not vary significantly with the choice of surgical modality.

Highlights

Patients with tumors of 3 to 5 cm were divided into stages T2a (3 to 4 cm) and T2b (4 to 5 cm) based on the 8th tumor-node-metastasis staging system for lung cancer
Non-small-cell lung cancer (NSCLC) tumors were divided according to the degree of differentiation, into well and moderately differentiated [3,763], poor and undifferentiated [2,844] or tumors with other degree of differentiation [389]
The present study focused on the new stages T2a and T2b in the 8th TNM staging system

Summary

Introduction

Patients with tumors of 3 to 5 cm were divided into stages T2a (3 to 4 cm) and T2b (4 to 5 cm) based on the 8th tumor-node-metastasis staging system for lung cancer. The TNM (tumor-node-metastasis) staging system, based on primary tumor size, number of lymph nodes affected, and the presence/absence of metastasis, is one of the most important lung cancer staging systems, according to the International Association for the Study of Lung Cancer (IASLC). The TNM (tumor-node-metastasis) staging system, based on primary tumor size, number of lymph nodes affected, and the presence/absence of metastasis, is one of the most important lung cancer staging systems, according to the International Association for the Study of Lung Cancer (IASLC)8 This staging system is used for prognosis in lung cancer patients and serves as guidelines in choosing appropriate treatment methods. Some recent studies have explored the most appropriate surgical modalities according to tumor size for NSCLC patients He et al showed that lobectomy was better than sublobar resection for NSCLC patients with tumors measuring 0 to 2 cm. We devoted to finding the appropriate surgical modalities for these patients

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