New Staging Proposal for Revision of

Non-small Cell Lung Cancer:

The Importance of New T Factors

Akif Turna, Necati Çıtak, Adnan Sayar, Nur Ürer, Atilla Gürses

Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey

Survival Rates in Resected Survival Rates in Resected Non-Small Cell Lung CancerNon-Small Cell Lung Cancer

Recursive Partitioning: Tekrarlayıcı Ayrıştırma

Text

n=100869

HYPOTHESISHYPOTHESIS

To test the Validity of New T To test the Validity of New T staging systemstaging system

Patients and MethodsPatients and Methods

✦Study Period : January 1995 - December 2007

✦Gender : 597 male, 52 female

✦ Mean Age : 56.9 (17 to 84) years

✦ Mean follow-up : 19 months

Preoperatif Work-upPreoperatif Work-up Thorax CT

‣ Bronchoscopy

‣ Cranial CT/MRI

‣ Whole body bone scintigraphy

‣ PET-CT (After 2003)

‣ Abdominal CT/USG

‣ Mediastinoscopy

‣ ‘Extended’ Mediastinoscopy/Mediastinotomy

SURGICAL ve PATHOLOGİC SURGICAL ve PATHOLOGİC PROCEDURES PROCEDURES

‣ Anterior / lateral torakotomi

‣ Lobectomy/Bilobectomy/Pneumonectomy

‣ Mediastinal lymph node dissection

‣ Pathologic evaluation: Hematoxylin-Eosin

Surgical Treatment and Surgical Treatment and Follow-upFollow-up

✦Lobectomy : 104(9 ‘sleeve’ )(75.4%)

✦Pnömonectomy : 22 (23.5%)

✦Bilobectomy : 10 (7.3%)

✦Wedge resection : 2 (1.5%)

✦TOTAL :138 patients were analyzed according to new

system

➡Follow-up : 21 months (mean)

➡Survival-Analysis: Kaplan-Meier / Log-rank test

Overall SurvivalOverall Survival

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Survival According to T FactorSurvival According to T Factor

T1

T2

T3T2T4

Survival of T2a and T2b Survival of T2a and T2b TumorsTumors

T2a

T2b

p=0.48

Survival of ‘New’ and ‘Old’ T3Survival of ‘New’ and ‘Old’ T3

Old T3

New T3

T2T2

p=0.61

ResultsResults

✦The prognosis of the patients with lung cancer

greater than 7 cm seemed to be similar to those with

T3 tumors.

✦However, The discrimination of proposed T2a and

T2b was not confirmed in our series