Does surgery have a role in T4N0 and T4N1 lung cancer?

Interactive Cardiovascular and Thoracic Surgery
Anthony ChambersMarco Scarci

Abstract

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed whether [surgery] has a role in [treatment of T4N0 and T4N1 lung cancer]. Altogether more than 151 papers were found using the reported search, of which 15 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that upfront surgery for locally invasive T4 tumours without mediastinal lymph node involvement (T4N0 and T4N1 non-small cell lung cancer) is of benefit in terms of survival rates in carefully selected patients. Overall five-year survival rates following resection of T4N0-N2 tumours vary from 19.1% to 57% (from six studies), within which, involvement of certain structures were found to greatly affect prognosis. Pulmonary artery invasion has a good prognosis (five-year survival; 52.8%) relative to other mediastinal structures [five-year survival: left atrium; N0; 28.94%, N1; 27.92%, N2; 17.95% (three-year survival), aorta; N0; 100%, N1; 37.1%, N2; 0%, superior vena cava (SVC); 11%, -29.4% (from four studies), carina; 28-42.5% (two studies), ve...Continue Reading

References

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Citations

Nov 2, 2012·Annals of Surgical Oncology·Keith SigelJuan Wisnivesky
Jan 24, 2012·World Journal of Surgical Oncology·Taichiro GotoRyoichi Kato
Mar 15, 2014·The Annals of Thoracic Surgery·Geraud GalvaingMarc Filaire
Aug 19, 2015·The Annals of Thoracic Surgery·Gita N ModyMichael T Jaklitsch
Mar 6, 2015·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Hidenori KusumotoYoshiki Sawa
Jan 22, 2014·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Bart ReymenDirk De Ruysscher
Aug 23, 2016·Journal of Surgical Oncology·Norberto Santana-RodríguezFaiz Y Bhora
Oct 22, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Keiji YamanashiHiroshi Date
Feb 23, 2019·General Thoracic and Cardiovascular Surgery·Hiroshi YabukiYoshinori Okada
Feb 15, 2011·Interactive Cardiovascular and Thoracic Surgery·Alper TokerSerkan Kaya
Sep 8, 2021·CA: a Cancer Journal for Clinicians·Arafat H TfayliFadlo R Khuri

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