Casali Christian1, Storelli Erica, Uliano Morandi. 1. Division of Thoracic Surgery, Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia, Policlinico di Modena, Largo del Pozzo 71, 41100 Modena, Italy.
Abstract
PURPOSE: The current TNM staging system for non-small cell lung cancer subdivides stage IA and IB according to a tumor size threshold of 3 cm. Some authors have suggested that tumor size behaves as a continuous, but the optimal diameter thresholds to be adopted remain debated. METHODS: We conducted a retrospective study on 548 patients who underwent a complete surgical resection at our institute for stage IA and IB non-small cell lung cancer according to the current TNM staging system. Univariate and multiaviate analysis of overall and disease-specific survival were performed. RESULTS: Stage IA had an overall 5 years survival of 67% and a 5 years disease-specific survival of 85%. Stage IB had an overall 5 years of 49% and 5 years disease-specific survival of 53%. Tumors <2 cm had a significantly better survival than tumors > or =2 cm (overall survival: p=0.007; disease-specific survival: p=0.026), as well as tumors ranging from 2 to 5 cm in comparison with larger ones (overall survival: p=0.031; disease-specific survival: p=0.013). No significant difference was found between groups ranging from 2 to 5 cm. Tumors of 2-5 cm had 57% higher probability of death in comparison with tumors <2 cm and tumors >5 cm had a probability of death 60% higher than tumor of 2-5 cm. Age and tumor size (two thresholds diameter classification) resulted independent variables at multivariate analysis. CONCLUSION: the definition of T factor in the staging system of non-small cell lung cancer should consider two cutoffs according to tumor size. Two and 5 cm represent appropriate thresholds diameters that define subgroups with significant different prognosis.
PURPOSE: The current TNM staging system for non-small cell lung cancer subdivides stage IA and IB according to a tumor size threshold of 3 cm. Some authors have suggested that tumor size behaves as a continuous, but the optimal diameter thresholds to be adopted remain debated. METHODS: We conducted a retrospective study on 548 patients who underwent a complete surgical resection at our institute for stage IA and IB non-small cell lung cancer according to the current TNM staging system. Univariate and multiaviate analysis of overall and disease-specific survival were performed. RESULTS: Stage IA had an overall 5 years survival of 67% and a 5 years disease-specific survival of 85%. Stage IB had an overall 5 years of 49% and 5 years disease-specific survival of 53%. Tumors <2 cm had a significantly better survival than tumors > or =2 cm (overall survival: p=0.007; disease-specific survival: p=0.026), as well as tumors ranging from 2 to 5 cm in comparison with larger ones (overall survival: p=0.031; disease-specific survival: p=0.013). No significant difference was found between groups ranging from 2 to 5 cm. Tumors of 2-5 cm had 57% higher probability of death in comparison with tumors <2 cm and tumors >5 cm had a probability of death 60% higher than tumor of 2-5 cm. Age and tumor size (two thresholds diameter classification) resulted independent variables at multivariate analysis. CONCLUSION: the definition of T factor in the staging system of non-small cell lung cancer should consider two cutoffs according to tumor size. Two and 5 cm represent appropriate thresholds diameters that define subgroups with significant different prognosis.
Authors: Lijuan Zhang; David F Yankelevitz; Claudia I Henschke; Artit C Jirapatnakul; Anthony P Reeves; Darryl Carter Journal: Radiology Date: 2010-08 Impact factor: 11.105
Authors: Jianjun Zhang; Kathryn A Gold; Heather Y Lin; Stephen G Swisher; Yan Xing; J Jack Lee; Edward S Kim; William N William Journal: J Thorac Oncol Date: 2015-04 Impact factor: 15.609
Authors: Katharine Lampen-Sachar; Binsheng Zhao; Junting Zheng; Chaya S Moskowitz; Lawrence H Schwartz; Maureen F Zakowski; Naiyer A Rizvi; Mark G Kris; Michelle S Ginsberg Journal: Lung Cancer Date: 2011-09-03 Impact factor: 5.705