Computed tomography (CT) predicts accurately the pathologic tumour size in stage I non-small-cell lung cancer (NSCLC)
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In stage I non-small-cell lung cancer (NSCLC) tumour size has been the most consistent determinant of survival. The choice of therapy option is based on accurate definition of the stage. The aim of our study is to correlate tumour size by computed tomography scan (CT) with pathologic size and to determine possible prognostic factors in surgically resected pathologic stage IA and IB NSCLC patients.
Retrospective review of CT scans and medical history data from 89 pathologic stage I NSCLC patients. Clinical prognostic factors analysed were age, gender, smoking status, pulmonary function, performance status (PS), surgical procedure, histopathology, vessel invasion, pleural infiltration, tumour size and number of lymph nodes resected. According to the new TNM classification for lung cancer, tumour size was divided into five groups (I: <2 cm, II: 2–3 cm, III: 3–5 cm, IV: 5–7 cm and V: >7 cm).
After a median surveillance of 55.2 months, 42 patients relapsed and 55 had died. The 5-year progressionfree survival was 55.7% and 5-year overall survival (OS) 49.9% (median 58.97 months). None of the clinical parameters analysed were predictors of OS. Significant correlation was found between tumour size in CT scan and pathologic stage (Pearson 0.75).
In our analysis with 89 surgically resected stage IA and IB NSCLC patients we found a good correlation between clinical and pathologic tumour size by CT scan. The prognoses factors analysed had no significant impact on survival.
KeywordsTumour size Prognostic factors Stage I Non-small-cell lung cancer
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- 6.Sobin LH, Wittekind Ch (eds) (2002) TNM classification of malignant tumours, 6th Edn. Wiley, New YorkGoogle Scholar
- 7.Groome PA, Bolejack V, Crowley J et al (2007) The IASLC Lung Cancer Staging Project: validation of the proposals for revision of the T,N and M descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol 2:694–705PubMedCrossRefGoogle Scholar
- 12.Berghmans T, Dusart M, Paesmans M et al (2008) Primary tumor standarized uptake value (SUV max) measured on fluordeoxyglucose positron emission tomography (FDG-PET) is of prognostic value for survival in non-small cell lung cancer (NSCLC): a systematic review and meta-anaysis by the European Lung Cancer Working Party for the IASLC Lung Cancer Staging Project. J Thorac Oncol 3:6–12PubMedCrossRefGoogle Scholar
- 21.Skrzypski M, Jassem E, Mendez P et al (2007) Expression profile of 29 genes by real-time quantitative PCR (RT-QPCR) in early-stage (I-IIIA) squamous cell carcinoma of the lung (SCCL). J Clin Oncol 25[Suppl]:abstract 7612Google Scholar
- 22.Tsao MS, Zhu C, Ding K et al (2008) A 15-gene expression signature prognostic for survival and predictive for adjuvant chemotherapy benefit in JBR.10 patients. J Clin Oncol 26[Suppl]:abstract 7510Google Scholar
- 25.Strauss GM, Herndon JE, Maddaus MA et al (2008) Adjuvant paclitaxel plus carboplatin compared with observation in stage IB non-small cell lung cancer: CALGB 9633 with the Cancer and Leukemia Group B, Radiation Therapy Oncology Group, and North Central Cancer Treatment Group Study Groups. J Clin Oncol 26:5043–5051PubMedCrossRefGoogle Scholar
- 38.Stiles BM, Servais EL, Lee PC et al (2009) Clinical stage IA non-small cell lung cancer determined by computed tomography and positron emission tomography is frequently not pathologic IA non-small cell lung cancer: the problem of understaging. J Thorac Cardiovasc Surg 137:13–19PubMedCrossRefGoogle Scholar