The following is a summary of “Completeness of Resection and Long-Term Survival of Patients Undergoing Resection for Pathologic T3 NSCLC: An International Association for the Study of Lung Cancer Analysis,” published in the January 2024 issue of Oncology by Figueroa, et al.

Currently, the T3 group of the eight-issue TNM classification for lung cancers includes tumors with different histopathologic features and oncologic results.

For a study, researchers sought to learn more about the T3 group. They looked through the amputations and how long the patients lived after the surgery for T3 NSCLC. The International Association for the Study of Lung Cancer database from 1999 to 2010 was searched for people who had lobectomy or pneumonectomy and were diagnosed with diagnostic T3N0M0 NSCLC. 

Overall survival (OS) was the main result that was looked at, broken down by T3 markers and the degree to which the removal was full. Out of 1,448 people with T3N0M0 cancers, 1,187 (82.0%) had a single trait identifying them as T3. It was most common for T3 tumors with chest wall infiltration (CWI) or parietal pleura infiltration (PL3) to have incomplete resection rates of 9.8% and 8.4%, respectively. T3 tumors that were only grouped by size had the lowest rate of incomplete resection rates of 2.9%. There were significant changes in OS between the T3 categories (P = 0.005). 

People with T3 tumors that were identified by size or the presence of a separate nodule (SN) in the same lobe had a better 5-year OS than people with PL3 or CWI tumors (size/SN 60% versus CWI/PL3 53%, P = 0.017), even if the tumors were completely removed. This was true even if the tumors were removed completely. Size, SN, PL3, or CWI T3 traits were linked to significant changes in 5-year OS. Putting abnormal T3N0M0 tumors into groups based on whether they have CWI or PL3 may help make tumor staging more accurate at predicting prognosis.

Source: sciencedirect.com/science/article/abs/pii/S155608642301078X