Investigation of clinical stage and surgical method of lung adenocarcinoma of trans-lobe type / 天津医药

ABSTRACT

Objective To explore the most accurate T staging and optimal surgical method of lung adenocarcinoma of trans-lobe type, and to provide supportive diagnosis as well as therapeutic evidences for this disease. Methods A total of 192 postoperative patients, hospitalized in Tianjin Medical University General Hospital from January 2008 to June 2013, who were diagnosed with lung adenocarcinoma were recruited. Patients were divided into three groups according to the 7th edition of TNM staging criteria issued by the IASLC in 2009. A total of 163 patients with T2 stage were selected as Group T2, and 12 patients with T3 stage were selected as Group T3, both of which were considered as control groups. Other 17 pa?tients who were diagnosed as trans-lobe type of lung adenocarcinoma, were Group trans-lobe. The clinical data and progno?sis were compared between three groups. The trans-lobe type of lung adenocarcinoma was diagnosed based on imaging and pathological examination. Subtypes of trans-lobe lung adenocarcinoma were identified by referring to 2011 international mul?tidisciplinary classification standard of lung adenocarcinoma. Kaplan-Meier method was used to analyze the prognosis of dif?ferent subtypes and surgical modus in patients with lung adenocarcinoma of trans-lobe type. Results By comparison, the postoperative survival rate was significantly lower in patients diagnosed with trans-lobe type of lung adenocarcinoma than that of Group T2 (P0.05). There were no significant differences in survival rates between different surgical modus (P<0.05). Seventeen patients with trans-lobe type of lung adenocarcinoma consisted of four subtypes, including 8 solid predominant, 5 acinar predominant, 3 papillary predomi?nant and 1 invasive mucinous adenocarcinoma. There were no statistical significances in postoperative survival time and sur?vival rates between four subtypes. Conclusion The clinical stage of trans-lobe type of lung adenocarcinoma should be clas?sified as stage T3. Both pulmonary bilobectomy and lobectomy combined with resection of proximal invaded lobe can be used as effective surgical therapies for trans-lobe type of lung adenocarcinoma.