Abstract
INTRODUCTION: Diaphragm invasion in non-small cell lung cancer (NSCLC) is a rare condition that accounts for less than 0.5%. It has been assessed as T3 according to the 7th edition of the TNM classification for lung cancer however surgical results were not clear. The aim of the study is to verify the validity of the new staging in NSCLC with diaphragm invasion.
METHODS: A retrospective review was carried out on 2195 consecutive patients with histologically proven NSCLC with anatomical lung resection between January 2010-June 2015. 14 patients with diaphragm resection for tumor invasion were analyzed.
RESULTS: Of all the 14 patients, mean age was 60 years. 12 patients had squamous cell carcinoma and 2 had adenocarcinoma. Eight patients out of the 14 were radiologically suspected to have diaphragm invasion. Diaphragm reconstruction was performed in three patients with polytetrafluoroethylene mesh. Six patients were pathologically staged as IIB (T3N0), 8 patients as stage IIIA (T3N1-N2). During the 15-month median follow-up period, all patients received adjuvant treatment, and 8 patients died. Median life expectancy was found to be 17 months. While the median life expectancy of stage IIB (T3N0) patients was 17 months, it was found as 16 months for stage IIIA (T3N1-N2) patients.
CONCLUSIONS: The results of our study are similar to the median life expectancy of T4 cases reported as being shorter. The fact that NSCLC with diaphragm invasion constitutes a very small group of patients within T3 and the results of the present study, supports that these patients would be categorized within T4 as indicated in the 8th edition of the TNM classification for lung cancer.
- Copyright ©the authors 2016
