Objective: To assess whether it is reasonable to downgrade intralobar metastatic non-small cell lung cancer from T4 disease through a prognostic analysis of N0-1M0 disease.
Methods: A retrospective analysis was conducted to assess the survival of patients with intralobar metastatic non-small cell lung cancer with pathological N0-1M0 disease. The Kaplan-Meier method was used to calculate the patient survival.
Results: Forty-six patients were included. The overall 5-year survival rate was 29.2% with a median survival of 53.0 months. The median survival was 24.0 months for patients with adenosquamous carcinoma; while for patients with other pathologic types, the median survival was 48 months. Adenosquamous carcinoma had a shorter survival time than other pathologic types (P = 0.003). The median survival time was 60.0 months for patients undergoing non-pneumonectomy resection and 24 months for patients undergoing pneumonectomy (P = 0.023).
Conclusion: It is reasonable to downgrade the T4 classification of non-small cell lung cancer with intralobar metastasis. However, pneumonectomy should be carried out with cautions. Adenosquamous carcinoma has a poor prognosis. Further study of a larger sample size is warranted.