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[Post-operative staging and survival based on the revised TNM staging system for non-small cell lung cancer]
1Tumor Hospital, Cancer Center, Sun Yet-sen University of Medical Sciences, Guangzhou 510060.
Objective:
To study the factors affecting post-operative staging and survival in non-small cell lung cancer (NSCLC) patients based on the revised TNM staging system adopted by the UICC in 1997.
Methods:
Data were collected from 1757 consecutively operated NSCLC patients, including those receiving complete tumor excision, tumor debulking and exploratory thoracotomy from April 1969 through Dec. 1993. The end point of follow-up was Nov. 30, 1998. Cumulative survival and its influencing factors were analyzed by Kaplan-Meier and Cox model of SPSS software.
Results:
In this series, 30 patients (1.71%) were lost from follow-up. The 5-year cumulative survival rate was 88.0% for patients in stage IA, 53.9% in stage IB, 33.5% in stage II, 14.7% in stage IIIA, 5.5% in stage IIIB and 7.0% in stage IV. The overall 5-year survival rate was 28.2%. The 5-year survival rate was 39.8%, 14.4% and 4.2% in patients treated with complete tumor resection, tumor debulking and exploratory thoracotomy, respectively. The 10-year survival rate was 31.4%, 9.5% and 0%, respectively. Factors affecting long-term cumulative survival, in the order of decreasing significance, were the type of operation, lymph node status, staging, size and pathologic type of the primary tumor.
Conclusion:
The revised staging system for NSCLC is superior to that used since 1986 as far as the end results of treatment in patients in different stage and the staging specificity are concerned. The T3N1M0 classification and the definition of M1 need to be further studied.