Postresection Irradiation for T2 N0 M0 Non–Small Cell Carcinoma: A Prospective, Randomized Study
- 1 August 1996
- journal article
- clinical trial
- Published by Elsevier BV in The Annals of Thoracic Surgery
- Vol. 62 (3), 830-834
- https://doi.org/10.1016/s0003-4975(96)00507-3
Abstract
Stage I nonirradiated T2 N0 non-small cell lung carcinoma has a postoperative prognosis not very different from stage II irradiated T1 N1 carcinoma. The hypothesis was that more locoregional malignant sites are overlooked in T2 N0 M0 than in T1 N0 M0 tumors, considering the better prognosis of this last group, and that T2 N0 cancer might benefit from postresection irradiation. From 1985 to 1991, 163 non-small cell lung carcinomas were classified T2 N0 M0 and randomized for irradiation or nonirradiation after operation. After revision of all the cases, 132 were included in this study: 60 were irradiated and 72 were not irradiated. All were followed up. The study was closed in October 1995. Statistical analysis was then performed considering volume, location, cell type, survival, and recurrence in the two groups. One hundred thirteen patients were followed up during a minimum of 5 years: the survival was 44.2%. There was no significant difference considering cell type or irradiation. There was no recurrence-free survivor beyond 5 years with a tumor invading the visceral pleura. At the close of the study (follow up, 4 years 3 months to 10 years 1 month), 49 of 132 patients were alive. The median survival was 3 years 11 months. Fifty-nine patients had died of local (21) or distant (40) recurrences (2 patients had both local and distant recurrence). There was again no significant difference considering cell type or irradiation, either in the survival or in the mode of recurrence. Stage I T2 N0 M0 non-small cell lung carcinoma tends to manifest distant metastasis. Prospective studies of stratified systemic adjuvant therapy should improve the present moderate result of radical resection in this group of tumors.Keywords
This publication has 15 references indexed in Scilit:
- Local and/or distant recurrences in T1-2/N0-1 non-small cell lung cancerEuropean Journal of Cardio-Thoracic Surgery, 1995
- The first site of recurrence after complete resection in non-small-cell carcinoma of the lungThe Journal of Thoracic and Cardiovascular Surgery, 1994
- Is T factor of the TNM staging system a predominant prognostic factor in pathologic stage I non-small-cell lung cancer?The Journal of Thoracic and Cardiovascular Surgery, 1993
- Survival and prognosis following resection of primary non small cell bronchogenic carcinomaEuropean Journal of Cardio-Thoracic Surgery, 1991
- Behavior of small bronchial carcinomasThe Annals of Thoracic Surgery, 1990
- Prognostic factors in resected stages I and II adenocarcinoma of the lungThe Journal of Thoracic and Cardiovascular Surgery, 1990
- Treatment of Stage II Lung Cancer (T1N1 and T2N1)Surgical Clinics of North America, 1987
- Treatment of Stage I Lung Cancer (T1N0M0, T2N0M0)Surgical Clinics of North America, 1987
- Lung cancer classification: The relationship of disease extent and cell type to survival in a clinical trials populationJournal of Surgical Oncology, 1987
- Sites of recurrence in resected stage I non-small-cell lung cancer: a guide for future studies.Journal of Clinical Oncology, 1984