Clinical tumour size and prognosis in lung cancer

In the staging of lung cancer (LC), tumour size is a variable that can be u sed to separate primary tumour, regional nodes, metastasis (TNM), stages T1 and T2 (<3 or >3 cm). The objective of this study was to evaluate tbe prog nostic value of tumour size before thoracotomy and to determine whether tum our size can be used to classify LC as T3. This multi-institutional cooperative longitudinal prospective study in Span ish hospitals located throughout the country, with a broad range of activit y levels, included all consecutive cases of LC treated surgically from Octo ber 1993 to September 1996 (n=2,361). Four prognostic groups, characterized by tumour size, were identified accor ding to the Schoenfeld procedure: a) 0-2 cm (n=173); b) 2.1-4 cm (n=542); c ) 4.1-7 cm (n= 413); and d) >7 cm (n=77). The 2-yr survival rates by group were a=0.78 (95% confidence interval (CI) 0.71-0.84); b=0.67 (95% CI 0.62-0 .71); c=0.58 (95% CI 0.53-0.63); d=0.41 (95% CI 0.29-0.52). The log-rank co mparisons of the survival curves were significant for the four groups (a ve rsus b=0.0008, b versus c=0.003, c versus d=0.016). The clinical tumour size of lung cancer defined four prognostic groups (0-2 em, 2.1-4 cm, 4.1-7 cm; and >7 cm). Lung cancer with a diameter >7 cm had a prognosis similar to that of stage T3 or stage IIB.