Clinical tumour size and prognosis in lung cancer. Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCB-S)

In the staging of lung cancer (LC), tumour size is a variable that can be used to separate primary tumour, regional nodes, metastasis (TNM), stages T1 and T2 (<3 or >3 cm). The objective of this study was to evaluate the prognostic value of tumour size before thoracotomy and to determine whether tumour size can be used to classify LC as T3. This multi-institutional cooperative longitudinal prospective study in Spanish hospitals located throughout the country, with a broad range of activity levels, included all consecutive cases of LC treated surgically from October 1993 to September 1996 (n=2,361). Four prognostic groups, characterized by tumour size, were identified according to the Schoenfeld procedure: a) 0-2 cm (n=173); b) 2.1-4 cm (n=542); c) 4.1-7 cm (n= 413); and d) >7 cm (n=77). The 2-yr survival rates by group were a=0.78 (95% confidence interval (CI) 0.71-0.84); b=0.67 (95% CI 0.62-0.71); c=0.58 (95% CI 0.53-0.63); d=0.41 (95% CI 0.29-0.52). The log-rank comparisons of the survival curves were significant for the four groups (a versus b=0.0008, b versus c=0.003, c versus d=0.016). The clinical tumour size of lung cancer defined four prognostic groups (0-2 cm, 2.1-4 cm, 4.1-7 cm; and >7 cm). Lung cancer with a diameter >7 cm had a prognosis similar to that of stage T3 or stage IIB.