HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Aart Brutel de la Rivière Henry A. van Swieten Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pitz, C. C.M. Articles by van den Bosch, J. M.M. Search for Related Content PubMed PubMed Citation Articles by Pitz, C. C.M. Articles by van den Bosch, J. M.M. Related Collections Lung - cancer

Eur J Cardiothorac Surg 2003;24:1013-1018
© 2003 Elsevier Science NL

Results of surgical treatment of T4 non-small cell lung cancer

^a Department of Pulmonology, Sint Antonius Hospital, PO BOX 2500, 3430 EM Nieuwegein, The Netherlands
^b Department of Cardio-Thoracic Surgery, University Medical Center, Utrecht, The Netherlands
^c Department of Thoracic Surgery, Sint Antonius Hospital, PO BOX 2500, 3430 EM Nieuwegein, The Netherlands
^d Department of Pulmonary Diseases, University Medical Center, Utrecht, The Netherlands

Received 7 April 2003; received in revised form 11 July 2003; accepted 23 July 2003.

^* Corresponding author. Tel.: +31-30-6092428; fax: +31-30-6052001
e-mail: j.vandenbosch{at}antonius.net

Objective: Because of location and invasion of surrounding structures, the role of surgical treatment for T4 tumors remains unclear. Extended resections carry a high mortality and should be restricted for selected patients. This study clarifies the selection process in non-small cell T4 tumors with invasion of the mediastinum, recurrent nerve, heart, great vessels, trachea, esophagus, vertebral body, and carina, or with malignant pleural effusion. Methods: From 1977 through 1993, 89 patients underwent resection for primary non-small cell T4 carcinomas. Resection was regarded as complete in 34 patients (38.2%) and incomplete in 55 patients (61.8%). Actuarial survival time was calculated and risk factors for late death were identified. Results: Overall hospital mortality was 19.1% (n=17). Mean 5-year survival was 23.6% for all hospital survivors, 46.2% for patients with complete resection and 10.9% for patients with incomplete resection (P=0.0009). In patients with complete resection, mean 5-year survival for patients with invasion of great vessels was 35.7%, whereas mean 5-year survival for invasion of other structures was 58.3% (P=0.05). Age, mediastinal lymph node involvement, type of operative procedure, and postoperative radiotherapy did not significantly influence survival. Conclusion: In certain T4 tumors complete resection is possible, resulting in good mean 5-year survival especially for tumors with invasion of the trachea or carina. High hospital mortality makes careful patient selection imperative.

Key Words: Lung cancer • Surgery • Survival

This article has been cited by other articles:

				H.-x. Yang, X. Hou, P. Lin, T.-h. Rong, H. Yang, and J.-h. Fu Survival and risk factors of surgically treated mediastinal invasion T4 non-small cell lung cancer. Ann. Thorac. Surg., August 1, 2009; 88(2): 372 - 378. [Abstract] [Full Text] [PDF]

				A. Borri, F. Leo, G. Veronesi, P. Solli, D. Galetta, R. Gasparri, F. Petrella, P. Scanagatta, D. Radice, and L. Spaggiari Extended pneumonectomy for non-small cell lung cancer: morbidity, mortality, and long-term results. J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1266 - 1272. [Abstract] [Full Text] [PDF]

				E. Pompeo, F. Tacconi, and T. C. Mineo Flexible Videopericardioscopy in cT4 Nonsmall-Cell Lung Cancer With Radiologic Evidence of Proximal Vascular Invasion Ann. Thorac. Surg., February 1, 2007; 83(2): 402 - 408. [Abstract] [Full Text] [PDF]

				J. Vojacek, J. Burkert, P. Pafko, M. Mates, J. Spatenka, and P. Pavel Extension of Pulmonary Adenocarcinoma into the Left Atrium Asian Cardiovasc Thorac Ann, October 1, 2006; 14(5): e99 - e101. [Abstract] [Full Text] [PDF]

				R. F. Munden, S. S. Swisher, C. W. Stevens, and D. J. Stewart Imaging of the Patient with Non-Small Cell Lung Cancer Radiology, December 1, 2005; 237(3): 803 - 818. [Abstract] [Full Text] [PDF]

				J. Klein, V. Kral, T. Bohanes, and M. Herman Five-year survival after sleeve pneumonectomy combined with the superior vena cava replacement for lung cancer Interactive CardioVascular and Thoracic Surgery, August 1, 2005; 4(4): 319 - 321. [Abstract] [Full Text] [PDF]

				C. A. DiPerna and D. E. Wood Surgical Management of T3 and T4 Lung Cancer Clin. Cancer Res., July 1, 2005; 11(13): 5038s - 5044s. [Abstract] [Full Text] [PDF]

				B. J. Park, M. Bacchetta, M. S. Bains, R. J. Downey, R. Flores, V. W. Rusch, and L. N. Girardi Surgical management of thoracic malignancies invading the heart or great vessels Ann. Thorac. Surg., September 1, 2004; 78(3): 1024 - 1030. [Abstract] [Full Text] [PDF]

				C.S. Pramesh, R. C. Mistry, G. H. Pantvaidya, and S. Raina Surgery for T4 non-small cell lung cancer Eur. J. Cardiothorac. Surg., April 1, 2004; 25(4): 661 - 661. [Full Text] [PDF]