Objective: The objective was to study outcomes in patients in a population registry who were surgically staged as having pT3N0 NSCLC according to the seventh and eighth editions of the TNM staging classification. Methods: Details of patients who underwent surgery for NSCLC staged as pT3N0M0 from 2010 to 2013 on the basis of the seventh edition of the TNM classification were retrieved from the Netherlands Comprehensive Cancer Organization. These data were next matched with corresponding pathology data from a nationwide registry. Patients were categorized into four major pT3 subgroups as follows: those with a tumor diameter more than 7 cm, those with separate tumor nodules in the same lobe (two or more nodules), those with parietal pleural invasion, and a mixed group (consisting mainly of those with a tumor diameter larger than 7 cm combined with parietal pleural invasion). Results: A total of 683 patients were eligible for analysis. The 3‐ and 5‐year overall survival (OS) rates for the subtype tumor diameter larger than 7 cm were 59.9% and 47.2%, respectively, and were comparable to the rates for the subtype with pleural invasion (50.4% and 45.3%), respectively. The mixed group had worse 3‐ and 5‐year OS rates (37.5% and 28.7%, respectively), which were comparable to the outcomes for TNM eighth edition–staged IIIB and pT4 cases in the International Association for the Study of Lung Cancer database. For the subtype two or more nodules, the 3‐ and 5‐year OS rates were 70.6% and 62.8%, respectively, with patients with adenocarcinoma showing a significantly better OS than did patients with squamous cell carcinoma: a 5‐year OS rate of 65.1% versus 47.2%, respectively (p < 0.001), suggesting that the prognosis for the adenocarcinoma subgroup may be comparable to that for the pT2 category, whereas squamous cell carcinoma nodules can remain pT3. Conclusion: This population analysis of overall survival rate by pT3N0 subcategory for NSCLC suggests that histologic type is a relevant descriptor in the category two or more nodules. The findings do not support migration of the group with a tumor diameter larger than 7 cm to the category pT4in the eighth edition of the TNM classification, and they suggest that a combination of two pT3 descriptors (the mixed group) merits migration to pT4.

中文翻译：

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一项基于人群的荷兰手术切除 T3N0 非小细胞肺癌结局研究，使用 TNM-7 和 TNM-8 进行定义；改变的理由和将组织学纳入分期算法的论据？

目的：目的是研究人口登记中根据 TNM 分期分类的第七版和第八版手术分期为 pT3N0 NSCLC 的患者的结果。方法：从荷兰综合癌症组织检索 2010 年至 2013 年根据第七版 TNM 分类分期为 pT3N0M0 的非小细胞肺癌手术患者的详细信息。这些数据接下来与来自全国登记处的相应病理数据相匹配。患者被分为四个主要的 pT3 亚组，如下所示：肿瘤直径超过 7 cm 的患者，同一叶中具有独立肿瘤结节的患者（两个或多个结节），具有壁层胸膜侵犯的患者，混合组（以肿瘤直径大于7cm合并壁层胸膜浸润为主）。结果：共有 683 名患者符合分析条件。肿瘤直径大于 7 cm 的亚型的 3 年和 5 年总生存率 (OS) 分别为 59.9% 和 47.2%，与具有胸膜侵犯的亚型的比率（50.4% 和 45.3%）相当， 分别。混合组的 3 年和 5 年 OS 率较差（分别为 37.5% 和 28.7%），这与国际肺癌研究协会数据库中 TNM 第八版 IIIB 期和 pT4 病例的结果相当. 对于亚型两个或多个结节，3 年和 5 年 OS 率分别为 70.6% 和 62.8%，腺癌患者的 OS 显着优于鳞癌患者：5 年 OS 率分别为 65.1% 和 47.2%（p < 0.001），表明腺癌亚组的预后可能与鳞癌亚组相当对于 pT2 类别，而鳞状细胞癌结节可以保持 pT3。结论：这项针对 NSCLC 的 pT3N0 亚类总生存率的人口分析表明，组织学类型是两个或更多结节的相关描述词。这些发现不支持将肿瘤直径大于 7 cm 的组迁移到 TNM 分类第八版中的 pT4 类别，并且他们认为两个 pT3 描述符的组合（混合组）值得迁移到 pT4。分别 (p < 0.001)，表明腺癌亚组的预后可能与 pT2 类别的预后相当，而鳞状细胞癌结节可以保持 pT3。结论：这项针对 NSCLC 的 pT3N0 亚类总生存率的人口分析表明，组织学类型是两个或更多结节的相关描述词。这些发现不支持将肿瘤直径大于 7 cm 的组迁移到 TNM 分类第八版中的 pT4 类别，并且他们认为两个 pT3 描述符的组合（混合组）值得迁移到 pT4。分别 (p < 0.001)，表明腺癌亚组的预后可能与 pT2 类别的预后相当，而鳞状细胞癌结节可以保持 pT3。结论：这项针对 NSCLC 的 pT3N0 亚类总生存率的人口分析表明，组织学类型是两个或更多结节的相关描述词。这些发现不支持将肿瘤直径大于 7 cm 的组迁移到 TNM 分类第八版中的 pT4 类别，并且他们认为两个 pT3 描述符的组合（混合组）值得迁移到 pT4。这种按 pT3N0 亚类 NSCLC 总生存率的人口分析表明，组织学类型是两个或更多结节的相关描述词。这些发现不支持将肿瘤直径大于 7 cm 的组迁移到 TNM 分类第八版中的 pT4 类别，并且他们认为两个 pT3 描述符的组合（混合组）值得迁移到 pT4。这种按 pT3N0 亚类 NSCLC 总生存率的人口分析表明，组织学类型是两个或更多结节的相关描述词。这些发现不支持将肿瘤直径大于 7 cm 的组迁移到 TNM 分类第八版中的 pT4 类别，并且他们认为两个 pT3 描述符的组合（混合组）值得迁移到 pT4。