Abstract
Purpose
Controversy exists with regard to the T category of non-small cell lung cancer (NSCLC) with adjacent lobe invasion (ALI), and dispute arises on assigning this subset into T2 or T3 category. We evaluated the effect of ALI on the survival of resected NSCLC ≤ 5 cm, with purpose of determining the most appropriate T category for this population.
Methods
The entire cohort was divided into three subgroups (ALI group, T2 group and T3 group). Kaplan–Meier with log-rank method was carried out to compare overall survival (OS) differences. Propensity score matching (PSM) was performed to minimize bias.
Results
A total of 12,564 eligible NSCLC cases (ALI group: 114 cases; T2 group: 10,046 cases; T3 group: 2404 cases) were included in this study. The incidence of ALI was about 0.9%. Before PSM, survival analyses demonstrated that no significant OS differences were observed between ALI group and T2 group, and between ALI group and T3 group, neither in the entire cohort analysis nor in the subgroup analysis. After PSM, there were 102 pairs and 98 pairs in the ALI and T2 matching group and ALI and T3 matching group, respectively. In the matched cohorts, survival curves showed that the OS of ALI group was comparable to that of T2 group (P = 0.950), but superior to that of T3 group (P = 0.012).
Conclusions
The current study proposed that NSCLC with ALI ≤ 5 cm should be still categorized as T2 category, which could improve staging accuracy.
Similar content being viewed by others
References
Dziedzic D, Rudzinski P, Langfort R, Orlowski T, Polish Lung Cancer Study G (2016) Results of surgical treatment and impact on T staging of non-small-cell lung cancer adjacent lobe invasion. Eur J Cardiothorac Surg 50: 423–427. https://doi.org/10.1093/ejcts/ezw110
Haam SJ, Park IK, Paik HC, Kim DJ, Lee DY, Lee JG, et al. (2012) T-stage of non-small cell lung cancer directly invading an adjacent lobe. Eur J Cardiothorac Surg 42:807–10; discussion 10–1. https://doi.org/10.1093/ejcts/ezs171
Kanzaki R, Ikeda N, Okura E, Kitahara N, Shintani Y, Okimura A et al (2012) Surgical results and staging of non-small cell lung cancer with interlobar pleural invasion. Interact Cardiovasc Thorac Surg 14:739–742. https://doi.org/10.1093/icvts/ivs094
Liu M, Wigle D, Wampfler JA, Dai J, Stoddard SM, Xue Z et al (2017) T category of non-small cell lung cancer invading the fissure to the adjacent lobe. J Thorac Cardiovasc Surg 154(1777–83):e3. https://doi.org/10.1016/j.jtcvs.2017.07.069
Miura H, Taira O, Uchida O, Kato H (1998) Invasion beyond interlobar pleura in non-small cell lung cancer. Chest 114:1301–1304. https://doi.org/10.1378/chest.114.5.130
Ohtaki Y, Hishida T, Yoshida J, Ishii G, Kawase A, Aokage K et al (2013) The clinical outcome of non-small cell lung cancer patients with adjacent lobe invasion: the optimal classification according to the status of the interlobar pleura at the invasion point. Eur J Cardiothorac Surg 43:302–309. https://doi.org/10.1093/ejcts/ezs268
Rami-Porta R, Ball D, Crowley J, Giroux DJ, Jett J, Travis WD et al (2007) The IASLC Lung Cancer Staging Project: proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol 2:593–602. https://doi.org/10.1097/JTO.0b013e31807a2f81
Rami-Porta R, Bolejack V, Crowley J, Ball D, Kim J, Lyons G, et al. (2015) The IASLC Lung Cancer Staging Project: Proposals for the Revisions of the T Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer. J Thorac Oncol 10: 990–1003. https://doi.org/10.1097/JTO.0000000000000559
Riquet M, Berna P, Arame A, Mordant P, Das Neves Pereira JC, Foucault C et al (2012) Lung cancer invading the fissure to the adjacent lobe: more a question of spreading mode than a staging problem. Eur J Cardiothorac Surg 41:1047–1051. https://doi.org/10.1093/ejcts/ezr143
Xiao Z, Cao C, Mei J, Liao H, Yan T, Liu L (2016) Should tumor with direct adjacent lobe invasion (Tdali) be assigned to T2 or T3 in non-small cell lung cancer: a meta-analysis. J Thorac Dis 8: 1956–65. https://doi.org/10.21037/jtd.2016.06.52
Yang HX, Hou X, Lin P, Yang H, Zeng CG, Rong TH et al (2009) Peripheral direct adjacent lobe invasion non-small cell lung cancer has a similar survival to that of parietal pleural invasion T3 disease. J Thorac Oncol 4:1342–1346. https://doi.org/10.1097/JTO.0b013e3181bbb284
Funding
The authors have not disclosed any funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflict of interest to declare.
Ethics statement
Permission was obtained to retrieve SEER data files with the reference number: 12962-Nov2019. Because patient data recorded in the SEER database does not involve any individual identification, therefore, the present study was dispensed with signing informed consent forms and acquiring ethical approval.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Cai, JS., Lin, QY. & Dou, XM. Is adjacent lobe invasion an T category upgrade factor for resected non-small cell lung cancer ≤ 5 cm?. J Cancer Res Clin Oncol 149, 1777–1784 (2023). https://doi.org/10.1007/s00432-022-04102-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00432-022-04102-1