A better prognostic value from a modification of lung cancer staging

This prospective study analyzes the survival rate, according to TNM and staging, of 538 patients who underwent curative pulmonary resection for non-oat cell tumors and who survived the operative period. A total of 279 patients had Stage I disease, 113 Stage II, and 146 Stage III. The overall survival rates were 72% at 1 year, 54% at 2 years, 47% at 3 years, 43% at 4 years, and 39% at 5 years. The survival curves of Stages I, II, and III are significantly different. Nevertheless, in Stage I, T1 N0 tumors presented the best survival rate (71% at 5 years), and this was significantly different from those of all other groups. For Stage II, the survival curves were significantly different according to hilar or lobar location of N1. The survival rate of T2 N1 hilar tumors was similar to that of T2 N2 tumors. In Stage III, the survival of T3 N2 tumors was the worst of all classifications. These results may contribute to a reappraisal of the surgical classification. T1 N0 tumors are worthy, on their own, of forming Stage I. T2 N0, T1 N1 lobar, and T2 N1 lobar can constitute Stage II. Stage III or IIIa would comprise carcinomas classified T2 N1 hilar, T1 N2, T2 N2, and perhaps T3 N0 and T3 N1. T3 N2 should probably be isolated in a IIIb or IV stage.