T-stage and surgical treatment of non-small cell lung cancer directly invading an adjacent lobe

Objective To determine the T-stage of non-small cell lung cancer with adjacent lobe invasion and evaluate the respiratory function changes of the patients undergoing different surgeries. Methods We evaluated patients with NSCLC who were pathologically confirmed as direct adjacent lobe invasion in Panzhihua municipal central hospital lately.Kaplan-Meier method was used to calculate the overall survival and progression free survival.Log-Rank test was used to compare the postoperative survival among these groups.Postoperative pulmonary functions and complications were compared among the patients as well. Results Five-year survival rate and median survival time in adjacent lobe invasion group, single-lobe invasion T2 and T3 group were 29.39% and 29 months, 46.90% and 52 months, 27.11% and 34 months respectively.The survival of adjacent lobe invasion T2a subgroup was similar with single-lobe invasion T2b subgroup, lower than single-lobe invasion T2a subgroup (P=0.029). No statistical difference was detected between adjacent lobe invasion T2b subgroup and adjacent lobe invasion T3 subgroup which close to the survival rate of single-lobe invasion T3 subgroup.In addition, postoperative FEV1% (P=0.041) had reached statistical significance when evaluate the postoperative rehabilitation of patients undergoing different surgeries. Conclusions T-stage should be revised as soon as the adjacent lobe invasion is confirmed.Our results suggest that lobectomy plus wedge resection could be considered as a feasible surgical option according to the better functional results and similar oncological outcome compared with bilobectomy or pneumonectomy. Key words: Non-small cell lung cancer; Neoplasm staging; Prognosis; Operation