TUMOR VOLUME AS A PREDICTOR OF SURVIVAL AFTER RESECTION OF NON-SMALL-CELL LUNG-CANCER (NSCLC)

Many factors have been individually related to outcome in populations of non-small-cell lung cancer (NSCLC) patients. Factors responsible fo r the outcome of an individual after surgical resection are poorly und erstood. We have examined the importance of 'tumour volume' in determi ning prognosis of patients following resection of NSCLC in a multivari ate model. Cox's proportional hazard analysis was used to determine th e relative prognostic significance of stage, patient age, gender, tumo ur cell-type, nodal score and estimated 'tumour volume' in 669 cases w ith NSCLC treated with surgical resection, of which 280 had died. All factors (except tumour cell-type, P=0.33) were individually related to survival (P<0.05). When examined together, survival time was signific antly and independently related to 'tumour volume' and stage (P<0.001) , and other factors ceased to be significant. In cases with stage I or II rumours, risk of death was found to increase significantly with in creasing estimated 'tumour volume' (23.8% relative increase in hazard of death per doubling of 'tumour volume', 95% confidence interval 13.2 -35.2%, P<0.001 stage I; P<0.006 stage II). In cases with stage IIIa t umours this factor alone was the significant prognostic variable. In c onclusion, an estimate of 'tumour volume' significantly improves predi ction of prognosis for individual NSCLC patients with UICC stage I or II tumours.