Appropriate surgical modalities for stages T2a and T2b in the eighth TNM classification of lung cancer. Issue 1 (December 2017)

• Record Type: Journal Article
• Authors: Bie, Fenglong; Qu, Xiao; Yang, Xudong; Pang, Zhaofei; Yang, Yufan; Liu, Shaorui; Dong, Wei; Du, Jiajun
• Is Part Of: Scientific reports. Volume 7:Issue 1(2017)
• Page Start: 1
• Page End: 10
• Publication Date: 2017-12
• Subjects: Natural history -- Research -- Periodicals; Biology -- Research -- Periodicals; Physical sciences -- Research -- Periodicals; Earth sciences -- Research -- Periodicals; Environmental sciences -- Research -- Periodicals; 502.85
• DOI: 10.1038/s41598-017-13495-w
• Languages: English
• ISSNs: 2045-2322

Abstract

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 $${\chi }^{2}$$ χ 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.