[Surgical Resection for Locally Advanced Lung Cancer]

Lung cancer invading neighboring anatomical structures is categorized as T3 or T4 and is regarded as locally advanced lung cancer. The 8th Edition Lung Cancer Stage Classification reclassified tumors 5~7 cm in size as T3 and tumors >7 cm or invading the diaphragm as T4. The purpose of this study was to evaluate the treatment results for resectable cT3-4N0-1M0 non-small cell lung cancer. From 1985 to 2016, 138 patients were surgically treated in our hospital, and their median follow-up was 78 months. Overall, the 5-year survival was 50%. According to the cT factor, the 5-year survival was 60% in patients with 5~7 cm tumors, 35% in patients with >7 cm tumors, and 58% in the group with chest wall invasion;however, no patients with tumors invading the diaphragm, pericardium or great vessels survived 5 years postoperatively. Preoperative chemotherapy was given to 16 patients( 12%), and 6 of those patients received chemoradiotherapy;40 patients (29%) received postoperative chemotherapy. All patients who received preoperative chemoradiotherapy followed by surgery had a complete resection and good pathological effects. While surgery alone is associated with an insufficient prognosis in patients with T3-T4 lung cancer, the addition of preoperative treatment is promising for improving survival.