Oda M, Kanamori T, Marukawa Y, Itoh Y, Ishikawa N, Tamura M, Go T, Watanabe S, Ohta Y, Watanabe G, Watanabe Y
Department of Surgery (I), Kanazawa University, School of Medicine, Japan.
Kyobu Geka. 2000 Oct;53(11):905-9.
The purpose of this study was to evaluate the results of new TNM staging system for lung cancer in 1997, especially T3N0M0, stage IIIA, stage IIIB, and pm. Five-year survival rates of the patients with stage IIIA and stage IIIB were 16% and 18% respectively (NS). Five-year survival rates of patients with T3N1M0, T1N2M0, T2N2M0, and T3N2M0 were 40%, 28%, 15%, and 3%, respectively. The prognosis of T3N2M0 was significantly worse than that of T3N1M0, T1N2M0, and T2N2M0. Five-year survival rates of the patients excluding pm 1 with T4N0M0, T4N1M0, T4N2M0, and T4N3M0 were 21%, 10%, 10%, and 0%, respectively. The prognosis of the patients with T4N0 was significantly better than that of T4N2 and T4N3. In the patients with pm, 5-year survival rates of the patients with pm 1 and pm 2 were 26% and 7%, respectively (p < 0.01). In the patients with pm 1, 5-year survival rates of the patients with N0 + N1 and N1 + N2 were 53% and 16%, respectively (p < 0.01). From our these results, we supported the new TNM system as putting T3N0M0 to stage IIB, putting pm 2 into stage IV. We proposed; 1) chest wall invasion with bone destruction stay in stage IIIA or is T4, 2) T3N1M0 is classified with stage IIB, 3) main stem bronchus invasion is classified with T2, 4) pm 1 is subdivide by N status. Furthermore, stage III seemed to be reasonably subdivided into T1-2N3M0, T4N0-1M0 as stage IIIA and T3-4N2, T1-4N3 as stage IIIB.
本研究的目的是评估1997年肺癌新TNM分期系统的结果，尤其是T3N0M0、IIIA期、IIIB期和pm。IIIA期和IIIB期患者的5年生存率分别为16%和18%（无显著性差异）。T3N1M0、T1N2M0、T2N2M0和T3N2M0患者的5年生存率分别为40%、28%、15%和3%。T3N2M0的预后明显差于T3N1M0、T1N2M0和T2N2M0。不包括pm 1的T4N0M0、T4N1M0、T4N2M0和T4N3M0患者的5年生存率分别为21%、10%、10%和0%。T4N0患者的预后明显好于T4N2和T4N3患者。在有pm的患者中，pm 1和pm 2患者的5年生存率分别为26%和7%（p<0.01）。在pm 1患者中，N0+N1和N1+N2患者的5年生存率分别为53%和16%（p<0.01）。根据我们的这些结果，我们支持将T3N0M0归为IIB期、将pm 2归为IV期的新TNM系统。我们建议：1）伴有骨质破坏的胸壁侵犯仍归为IIIA期或为T4；2）T3N1M0归为IIB期；3）主支气管侵犯归为T2；4）pm 1根据N状态进行细分。此外，III期似乎可合理细分为T1-2N3M0、T4N0-1M0为IIIA期，T3-4N2、T1-4N3为IIIB期。
