The role of surgery in stage IIIa non-small cell lung cancer. Surgery in IIIa NSCLC.

The authors have reviewed the records of 50 consecutive patients resected for stage IIIa non-small cell lung cancer and included in a long-term follow-up study at the 1st Department of Surgery, University of Rome "La Sapienza". Overall survival was 60-20-16.6-16.6% at 1-5-7-10 years with an incidence of recurrence and/or metastasis respectively of 56-80-85.6-85.6%. These percentages were not influenced by the histological type. Tumours with the best prognosis were those classified as T1N2 and T3N0 (7-year survival rate: 33.3 and 29.4% respectively). Tumours with the worst prognosis were those classified as T3N2 with the highest incidence of relapse after 6 months (T3N0 vs T3N2 0.01 < p < 0.025) and no survival after 3 years (T3N0 vs T3N2 0.005 < p < 0.01). Regarding T3 tumours, infiltration of mediastinal pleura or pericardium was a negative prognostic factor implying no survival at 30 months. Involvement of chest wall or parietal pleura showed better survival overall although not statistically significant (10-year survival rate: 37.4 vs 24% respectively).