Surgical results and prognostic factors in early non-small cell lung cancer

We attempted to clarify the prognostic value of tumor size (maximum, 3 cm), the evidence of invasion proximal to a lobar bronchus at least 2 cm distal to the carina, and the absence or presence of visceral pleura invasion in patients with completely resected non-small cell lung carcinoma without lymph node invasion or satellite lesions (T1 N0 M0, T2 N0 M0).

The study included 158 patients. Four patients were excluded due to postoperative mortality (2.5%). The variables selected for the survival study were sex, age, symptoms presence or absence, bronchial invasion level (evidence or not of invasion proximal to a lobar bronchus at least 2 cm distal to the carina), pulmonary location, pneumonectomy or lesser resection, cell type, squamous or nonsquamous, tumor size, invasion or not of the visceral pleura, and T1 or T2 status.

The overall survival rate in this series was 74% at 5 years and 60% at 10 years. Only the tumor size had a significant influence on survival (p = 0.0092). Patients with a tumor less than 2 cm in diameter did better (p = 0.0023).

These observations suggest that it will be necessary to further research in clarifying the prognostic value of the bronchial invasion level and of the degree of the visceral pleura invasion and its implications when classifying a tumor as T1 or T2.