Mizushima Y, Noto H, Kusajima Y, Sugiyama S, Yamashita R, Sassa K, Kobayashi M
First Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, 930-01, Japan.
Oncol Rep. 1998 Mar-Apr;5(2):437-40.
In the new TNM staging system for lung cancer in 1997, stage T3N0M0 was revised from stage IIIA to stage IIB. Therefore, we initiated a study to assess the appropriateness of this revision. One hundred and nineteen patients who had undergone pneumonectomy for non-small cell lung cancer (NSCLC) between January 1985 and March 1996 were analyzed. They included 87 squamous cell carcinoma (sq), 25 adenocarcinoma (ad), 4 large cell carcinoma (la), and 3 adenosquamous cell carcinoma (ad-sq), with 10 patients in postoperative stage I (3 IA + 7 IB), 29 stage II (1 IIA + 28 IIB), 74 stage III (39 IIIA + 35 IIIB) and 6 in stage IV of the disease. Stage IIB included 14 patients with T3N0M0 (12 sq, 1 ad, 1 la). The 5-year survival rate for patients with T3N0M0 was 69.6%, which was superior to that (55.7%) for patients with stage II (T1-2N1M0) of the previous system. According to the new TNM staging system, the 5-year survival rate was 40% in stage I, 66.2% in stage II, 24% in stage IIIA, 0% in stages IIIB and IV (stage I vs stage II, NS; stage II vs stage IIIA, p<0.01; stage IIIA vs stage IIIB, p<0.01; stage IIIB vs stage IV, p<0.01). A significant prognostic difference between stage II and stage IIIA was observed, which had not been observed in the previous system. Our results show that the revision of T3N0M0 from stage IIIA to stage II in the new TNM staging system seems appropriate with regard to the pneumonectomy group.
在1997年肺癌新的TNM分期系统中，T3N0M0期从IIIA期修订为IIB期。因此，我们开展了一项研究以评估这一修订的合理性。分析了1985年1月至1996年3月间因非小细胞肺癌（NSCLC）接受肺切除术的119例患者。其中包括87例鳞状细胞癌（sq）、25例腺癌（ad）、4例大细胞癌（la）和3例腺鳞癌（ad-sq），术后I期患者10例（3例IA + 7例IB），II期29例（1例IIA + 28例IIB），III期74例（39例IIIA + 35例IIIB），IV期6例。IIB期包括14例T3N0M0患者（12例sq，1例ad，1例la）。T3N0M0患者的5年生存率为69.6%，高于既往系统中II期（T1-2N1M0）患者的5年生存率（55.7%）。根据新的TNM分期系统，I期5年生存率为40%，II期为66.2%，IIIA期为24%，IIIB期和IV期为0%（I期与II期比较，无显著性差异；II期与IIIA期比较，p<0.01；IIIA期与IIIB期比较，p<0.01；IIIB期与IV期比较，p<0.01）。观察到II期和IIIA期之间存在显著的预后差异，而这在既往系统中未观察到。我们的结果表明，在新的TNM分期系统中，将T3N0M0从IIIA期修订为II期对于肺切除术组而言似乎是合理的。
