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Prognostic significance of the non-size based AJCC T2 descriptors: visceral pleura invasion (VPI), hilar atelectasis or obstructive pneumonitis in stage IB non-small-cell lung cancer (NSCLC) is dependent on tumor size.

¹Chao Family Comprehensive Cancer Center, Division of Hematology/Oncology, Department of Medicine, University of California Irvine Medical Center, Orange, CA 92868 ²Genetic Epidemiology Research Institute; and ³Department of Epidemiology, School of Medicine, University of California Irvine, Irvine CA 92697

ignatius.ou{at}uci.edu

Abstract

Background: The T2 descriptor for staging non-small-cell lung cancer (NSCLC) contains several non-size based criteria. It remains unknown whether the prognostic significance of these non-size based criteria is dependent on tumor size.

Methods: 10,545 stage IB NSCLC patients from the California Cancer Registry (CCR) between 1989 to 2003 were categorized into three non-overlapping criteria: 1) tumor size (T2S); 2) visceral pleura invasion (VPI), hilar atelectasis or obstructive pneumonitis (T2P); 3) main bronchus involvement 2 cm from the carina (T2C). Univariate survival analyses were performed using Kaplan-Meier method. Multivariate survival analyses were performed using Cox proportional hazards ratios.

Results: 51.1% of IB patients were stage by T2S, 43.2% by T2P, and 5.7% by T2C. 2,224 (21.1%: 18.9% T2P + 2.2% T2C) stage IB patients had tumors 3 cm. The 5-year survivorship and median survival of these IB patients with tumors 3 cm: T2P = 51.2% and 64 months; T2C = 49.0% and 58 months were similar to the 53.2% 5-year survivorship and 67 months median survival for stage IA patients (p = 0.40). Cox proportional hazards model revealed T2P > 3 cm was a poor prognostic factor for survival (vs. T2S, hazard ratio [HR] = 1.16, 95% confidence interval (CI) = 1.08-1.24). Conversely, T2P 3 cm was a favorable prognostic factor for survival (vs. T2S, HR = 0.89, 95% CI = 0.82 -0.96). T2C was not an independent prognostic factor for survival.

Conclusions: Prognostic significance of non-size based T2 descriptor, T2P, is dependent on tumor size.

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Staging of Lung Cancer

Robert Milroy
Chest 2008 133: 593-595. [Full Text] [PDF]

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				R. Milroy Staging of Lung Cancer Chest, March 1, 2008; 133(3): 593 - 595. [Full Text] [PDF]