PURPOSE: To determine whether interlobar pleural invasion into the adjacent lobe (interlobar P3) should be assessed as T3 according to the tumor-node metastasis classification. METHODS: Surgically treated patients with primary lung cancer (n = 322) were analyzed. RESULTS: Tumors with interlobar P3 had a significantly lower incidence of mass screening detection, a higher occurrence rate of squamous cell carcinoma, and a larger tumor diameter than tumors without interlobar P3. The lymph node metastatic rate did not differ between the patients with and without interlobar P3. The 5-year survival rate of patients with interlobar P3 was 63% and the rates of other patients were 56% with T1 disease, 57% with T2, 31% with T3, and 19% with T4. The survival rate for patients with interlobar P3 was higher than for those with T3 without interlobar P3 (P < 0.05). The 5-year survival rate of the patients with interlobar P3 was lower in adenocarcinoma (39%) than in squamous cell carcinoma (69%, P < 0.01). The results were similar when the analysis was restricted to patients without lymph node metastasis. In adenocarcinoma, the survival rate for interlobar P3 was between the rates for T2 (53%) and T3 (13%) without interlobar P3, whereas in squamous cell carcinoma, the survival rate for interlobar P3 was between the rates for T1 (88%) and T2 (54%) without interlobar P3. CONCLUSION: Tumors with interlobar P3 should be classified as T2 only in squamous cell carcinoma.
PURPOSE: To determine whether interlobar pleural invasion into the adjacent lobe (interlobar P3) should be assessed as T3 according to the tumor-node metastasis classification. METHODS: Surgically treated patients with primary lung cancer (n = 322) were analyzed. RESULTS:Tumors with interlobar P3 had a significantly lower incidence of mass screening detection, a higher occurrence rate of squamous cell carcinoma, and a larger tumor diameter than tumors without interlobar P3. The lymph node metastatic rate did not differ between the patients with and without interlobar P3. The 5-year survival rate of patients with interlobar P3 was 63% and the rates of other patients were 56% with T1 disease, 57% with T2, 31% with T3, and 19% with T4. The survival rate for patients with interlobar P3 was higher than for those with T3 without interlobar P3 (P < 0.05). The 5-year survival rate of the patients with interlobar P3 was lower in adenocarcinoma (39%) than in squamous cell carcinoma (69%, P < 0.01). The results were similar when the analysis was restricted to patients without lymph node metastasis. In adenocarcinoma, the survival rate for interlobar P3 was between the rates for T2 (53%) and T3 (13%) without interlobar P3, whereas in squamous cell carcinoma, the survival rate for interlobar P3 was between the rates for T1 (88%) and T2 (54%) without interlobar P3. CONCLUSION:Tumors with interlobar P3 should be classified as T2 only in squamous cell carcinoma.
Authors: Ming Liu; Dennis Wigle; Jason A Wampfler; Jie Dai; Shawn M Stoddard; Zhiqiang Xue; Francis C Nichols; Gening Jiang; Ping Yang Journal: J Thorac Cardiovasc Surg Date: 2017-08-17 Impact factor: 5.209