Özet:

Aim: According to the 8th TNM lung cancer staging, T3 tumors are a heterogeneous group and the tumor accepted as T3 due to tumor diameter (5 to 7 cm), invasion the adjacent tissue (thoracic wall, pericardium, phrenic nerve, parietal pleura) and satellite malignant nodule in the same lobe. In our study, the survival difference between T3 tumor subgroups in the same stage (stage IIB) was investigated. Material and methods: Following the approval of the local ethics committee, patients who were operated with a diagnosis of NSCLC between January 2010 and December 2018 and whose pathological staging was reported as pT3N0M0 were included. The data of patients were analyzed according to age, gender, pT3 subgroup, histopathological type, tumor diameter, visceral pleural invasion.  Results: A total of 83 patients fulfilled the inclusion criteria were included in the study. 72 (%86.8) of the patients were male and 11 (13.2 %) were female. The median age was 62 (36-81) and mean tumor diameter was 4.9 cm (SD:2.1). The surgical resections were as follows;  lobectomy was performed in 45 patients (54.2%), bilobectomy in 9 patients (12.1 %), pneumonectomy in 14 patients (16.9 %), segmentectomy  in 3 patients (3.6%) and lung resection with chest wall resection in 11 patients (13.2 %). The pT3 subgroups were as follows, 38 (45.2%) diameter subgroups, 11 (13.7%) invasion subgroups, 7 (8.5%) parietal pleural invasion subgroups (without chest wall invasion), 10 (12.1%) satellite nodule subgroups and 17 (20.5%) multi-mix subgroups. The worst median survival was 22 months (7.1-37.0) in the invasion subgroup, while the best survival was in the diameter subgroup (median survival was 68.8 months, range 43.9-89.6 months). The difference was statistically significant (p = 0.001). Survival in the pneumonectomy group was significantly worse (p = 0.005). Conclusion: In non-small cell lung cancer, tumors of the same pathological stage may show a significant survival difference between subgroups. If these results are supported by more centered and studies including more patients, there may be additional factors in lung cancer staging.

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