Is there a prognostic difference among T3N0-3M0 NSCLC patients with different T3 descriptors?

OBJECTIVES
We aimed to evaluate the survival disparities among the T3N0-3M0 non-small cell lung cancer (NSCLC) patients with different T3 descriptors, and further externally validate the current T3 category.


METHODS
Overall survival (OS) and cancer-specific survival (CSS) were compared using the Kaplan-Meier method with a log-rank test. Univariable and multivariable Cox regression model was performed to determine the prognostic factors.


RESULTS
A series of 28,519 eligible cases were included. There were 17,971 cases, 3,028 cases, 4,600 cases and 2,900 cases in the tumors with size larger than 5 cm but equal to or less than 7 cm (T-size), tumors with chest wall/pericardium/phrenic nerve invasion (T-invasion), tumors with additional tumour nodules in the same lobe (T-add) and tumors had at least two T3 descriptors (T-multiple) group, respectively. The survival data indicated that T-add patients had the best survival rates than other T3 patients both in the entire cohort and in the subgroup analyses. Multivariable Cox models indicated that T3 descriptors was an important prognostic factor. Regarding the patients with different T3 descriptors, T-add patients had the best prognosis both in the pathological and clinical TNM stage cohorts, followed by T-size and T-multiple patients, and T-multiple patients had the least prognosis.


CONCLUSIONS
T3N0-3M0 NSCLC patients with different T descriptors had inconsistent survival rates. T-add yielded the best survivals, followed by T-size and T-invasion, and T-multiple was associated with the worst survivals. Our results were exploratory in nature and needed to be further validated.