{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T19:50:05Z","timestamp":1780775405733,"version":"3.54.1"},"reference-count":19,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>T4 lung cancer has become a more heterogeneous group since the 8th edition of tumour, node, metastasis classification. The aim of this study was to identify predictive factors related to post-surgical survival in patients with clinical T4 non-small-cell lung cancer (NSCLC), based on the 8th edition of the classification.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We retrospectively reviewed consecutive patients with clinical T4 NSCLC who underwent resection between January 2006 and December 2016, to identify factors associated with overall survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Ninety-three patients were identified. The criteria for clinical T4 disease included tumours larger than 7\u2009cm (n\u2009=\u200954), great vessels or left atrial invasion (n\u2009=\u200922), mediastinal invasion (n\u2009=\u200911), vertebral invasion (n\u2009=\u20093), tracheal or carina invasion (n\u2009=\u20093), diaphragm invasion (n\u2009=\u20091) and ipsilateral different lobe pulmonary metastasis (n\u2009=\u20092). The postoperative nodal status was 0, 1, 2 and 3 in 59, 18, 15 and 1 patient, respectively. R0 resection was achieved in 80 patients, and the 30-day mortality was 0%. The median follow-up time was 37.6\u2009months, and the 5-year overall survival rate was 56.3%. The multivariable analysis revealed that nodal status and R-status were significant prognostic factors for postoperative survival [hazard ratio (HR) 2.62, 95% confidence interval (CI) 1.20\u20135.72, P\u2009=\u20090.016 and HR 3.29, 95% CI 1.45\u20137.44, P\u2009=\u20090.004].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Surgery provided encouraging survival outcomes for clinical T4 NSCLC based on the 8th edition of classification. The nodal status and R-status were significant prognostic factors for postoperative survival.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezz288","type":"journal-article","created":{"date-parts":[[2019,10,2]],"date-time":"2019-10-02T11:13:17Z","timestamp":1570014797000},"source":"Crossref","is-referenced-by-count":5,"title":["Prognostic factors related to postoperative survival in the newly classified clinical T4 lung cancer"],"prefix":"10.1093","author":[{"given":"Keiji","family":"Yamanashi","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7341-6002","authenticated-orcid":false,"given":"Toshi","family":"Menju","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9808-8260","authenticated-orcid":false,"given":"Masatsugu","family":"Hamaji","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satona","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yojiro","family":"Yutaka","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, 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