Objective: To determine the postoperative survival of non-small cell lung cancer with peripheral adjacent lobe invasion by comparing it with that of resectable T4 disease with mediastinal structures invasion, and hence try to find out some clue concerning how to define these patients for a reasonable T stage.
Methods: A retrospective analysis was conducted to assess the survival of NSCLC patients with peripheral direct adjacent lobe invasion (group A, n = 28), and compared it with that of with mediastinal structures invasion (group B, n = 21). All patients underwent surgery between March, 1997 and October, 2006, and were pathologically confirmed with NOMO disease. Kaplan-Meier method was used to calculate the survival, and Log-Rank test was used to compare the postoperative survival between two groups.
Results: The sex, age, pathology, and pulmonary function were well balanced between the two groups. There was one operative death from group A. The disease specific 2 year, 3year, 5 year survival in group A and group B was: 68.7%, 61.1%, 40.7%, and 64.7%, 58.2%, 43.7%, respectively. The median survival for group A and group B was 54 months and 49 moths, respectively, with no statistically significant difference (P = 0.931).
Conclusions: NSCLC with peripheral adjacent lobe invasion has a similar survival prognosis with that of resectable T4 disease with mediastinal structures invasion. Among carefully selected patients, long-term survival is anticipated for NSCLC with adjacent lobe invasion. However, further studies are needed to determine the optimal T stage for these patients.