Lung Cancer Staging: A Case for a New T Definition
| Autor: | Kangmin Zhu, Charles R. Mulligan, Amir D. Meram, Aizen J. Marrogi, Courtney D. Proctor, Hongyu Wu |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
Risk Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Cohort Studies Humans Medicine Life Tables Neoplasm Invasiveness Registries Lung cancer Survival rate Survival analysis Neoplasm Staging Proportional Hazards Models business.industry Proportional hazards model Hazard ratio Age Factors medicine.disease Survival Analysis Confidence interval Survival Rate Military Personnel Treatment Outcome Relative risk Pleura Female Surgery Radiology Lung cancer staging Cardiology and Cardiovascular Medicine Nuclear medicine business Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 82:220-226 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2006.02.032 |
| Popis: | Background The purpose of this study is to determine a more refined T definition for lung cancer staging on the basis of clinical outcomes. Methods The Walter Reed Army Medical Center Tumor Registry and the Thoracic Surgery Tumor Clinic files were queried for lung cancers diagnosed from 1990 to 2000. Cox regression analysis and Kaplan–Meier survival curves for tumor size were used to analyze the impact of size on survival and relative risk, and then used to redefine T. Using the new T definition, the cohort was restaged, and the two staging system survivals were compared using Cox regression analysis. Results Tumor size was documented in 439 males and 226 females. Forty-two tumors were 1.0 cm or less, 133 were between 1.01 and 2.0 cm, 133 were between 2.01 and 3.0 cm, 91 were between 3.01 and 4.0, 96 were between 4.01 and 5.0, and 166 were greater than 5.0 cm. A survival advantage was noted for smaller lesions, with 5-year survivals of 48.6%, 45.9%, 26.6%, 27.0%, 14.4%, and 11.6%, respectively. Cox regression analysis revealed increased risk at 2.0 cm (hazards ratio, 2.014; 95% confidence interval, 1.24 to 3.26), 4.0 cm (hazards ratio, 2.51; 95% confidence interval, 1.53 to 4.09), and 5.0 cm (hazards ratio, 3.14; 95% confidence interval, 1.96 to 5.02). After redefining T, the new staging system showed a better 5-year survival in each stage. Conclusions Lung cancer tumor size criteria should be changed to include T1 tumors 2.0 cm and less; T2 tumors between 2.0 and 4.0 cm or pleural invasion of T1 tumor; T3 tumors greater than 4.0 cm or pleural invasion of T2 tumors. |
| Databáze: | OpenAIRE |
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