J. Jassem et al., Results of surgical treatment of non-small cell lung cancer: Validation ofthe new postoperative pathologic TNM classification, J THOR SURG, 119(6), 2000, pp. 1141-1146
Citations number
15
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objective: Prognostic relevance of the current TNM stage grouping for lung
cancer is still a matter of debate.
Methods: To validate the new pathologic TNM classification for non-small ce
ll lung cancer, we analyzed the survival data of 586 patients who underwent
complete pulmonary resection and pathologic staging at one institution.
Results: The current TNM stage grouping well reflected the long-term progno
stic hierarchy. There was a good distinction between new substages IA and I
B (5-year survivals of 66% and 53%, respectively). The subdivision of stage
II led to an under-representation of stage IIA (6 patients [1.0%]), and th
erefore the appropriateness of this modification could not be verified. Fiv
e-year survival in the T3 N0 category (30%) was significantly better than t
hat found in the new stage IIIA (15%). No difference was found between T3 N
O and T2 N1, the categories constituting new stage IIB. Within stage IIIA t
here was a significant survival difference between T3 N2 (6%) and the remai
ning T and N designations (18%). Moreover, the 5-year survival in the T3 N1
category (35%) was similar to that found in the new stage LIE (27%) and be
tter than in any T N2 tumors (12%).
Conclusion: Most of our findings confirmed prognostic relevance of the curr
ent pTNM stage grouping in patients with resectable non-small cell lung can
cer. However, despite recent modifications, there is still a significant he
terogeneity that flaws stage IIIA.