| Popis: |
Introduction: Staging of lung cancer is an important predictor of survival. The last review of the TNM staging divides the M1 descriptor into M1a (pulmonary contralateral metastases or pleural/pericardial effusion) and M1b (extrapulmonary metastases). Despite this division, patients staged M1a or M1b are categorized as stage IV. Aims: To analyze the survival of patients with non-small cell lung cancer (NSCLC) with and without metastases and to compare the survival of patients classified as M1a and M1b. Methods: Retrospective study in patients diagnosed with NSCLC in a Lung Oncology Unit between 2010 and 2011. Patients were divided into 3 groups (M0, M1a, M1b). The median survival was estimated by Kaplan-Meier method and other prognostic factors were evaluated by Cox regression analysis. Results: 216 patients included, mean age 65±11 years, 73% men. The most common histological type was adenocarcinoma (64%). 104 (48%) were in stage IV; 17% were M1a, 31% M1b. There were no statistically significant differences between M0, M1a and M1b groups regarding age, gender, smoking history and histological type. At the time of the study, 47 (22%) patients were alive. The median survival of patients M0, M1a and M1b was 22, 11, and 6 months, respectively (p Other factors associated with reduced survival were older age (HR=1.036, p Conclusions: NSCLC prognosis of M1a and M1b patients is different. M1a patients have a median survival almost twice longer than M1b patients (11 vs. 6 months). We suggest that stage IV may be divided into IVa and IVb in order to improve the predictive accuracy of TNM staging. In addition, male gender and older age seems to be associated with worse prognosis. |
