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New Staging Proposal for Revision of Non-small Cell Lung Cancer: The Importance of New T Factors

New Staging Proposal for Revision of Non-small Cell Lung Cancer: The Importance of New T Factors. Akif Turna, Necati Çıtak, Adnan Sayar, Nur Ürer, Atilla Gürses Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.

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New Staging Proposal for Revision of Non-small Cell Lung Cancer: The Importance of New T Factors

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  1. New Staging Proposal for Revision of Non-small Cell Lung Cancer: The Importance of New T Factors • Akif Turna, Necati Çıtak, Adnan Sayar, Nur Ürer, Atilla Gürses • Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey

  2. Survival Rates in Resected Non-Small Cell Lung Cancer

  3. Recursive Partitioning: Tekrarlayıcı Ayrıştırma

  4. n=100869 Text

  5. HYPOTHESIS • To test the Validity of New T staging system

  6. Patients and Methods • Study Period : January 1995 - December 2007 • Gender : 597 male, 52 female • Mean Age : 56.9 (17 to 84) years • Mean follow-up : 19 months

  7. Preoperatif Work-up • Thorax CT • Bronchoscopy • Cranial CT/MRI • Whole body bone scintigraphy • PET-CT (After 2003) • Abdominal CT/USG • Mediastinoscopy • ‘Extended’ Mediastinoscopy/Mediastinotomy

  8. SURGICAL ve PATHOLOGİC PROCEDURES • Anterior / lateral torakotomi • Lobectomy/Bilobectomy/Pneumonectomy • Mediastinal lymph node dissection • Pathologic evaluation: Hematoxylin-Eosin

  9. Surgical Treatment and Follow-up • Lobectomy : 104(9 ‘sleeve’ )(75.4%) • Pnömonectomy : 22 (23.5%) • Bilobectomy : 10 (7.3%) • Wedge resection : 2 (1.5%) • TOTAL :138 patients were analyzed according to new system • Follow-up : 21 months (mean) • Survival-Analysis: Kaplan-Meier / Log-rank test

  10. Overall Survival Text

  11. Survival According to T Factor T1 T2 T3 T4 T2

  12. Survival of T2a and T2b Tumors T2a T2b p=0.48

  13. T2 T2 Survival of ‘New’ and ‘Old’ T3 New T3 Old T3 p=0.61

  14. Results • The prognosis of the patients with lung cancer greater than 7 cm seemed to be similar to those with T3 tumors. • However, The discrimination of proposed T2a and T2b was not confirmed in our series

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