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Composite anatomic-clinical-molecular prognostic model in non-small-cell lung cancer: a multicenter study of 512 patients

A. López-Encuentra, F. López-Ríos, E. Conde, R. García-Luján, A. Suárez-Gauthier, N. Mañes, G. Renedo, J.L. Duque-Medina, E. García-Lagarto, R. Rami-Porta, G. González-Pont, J. Astudillo-Pombo, J.L. Maté-Sanz, J. Freixinet, T. Romero-Saavedra, M. Sánchez-Céspedes, A. Gómez de la Camara on behalf of the Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCB-S)
European Respiratory Journal 2010; DOI: 10.1183/09031936.00028610
A. López-Encuentra
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  • For correspondence: lencuent@h12o.es
F. López-Ríos
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E. Conde
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R. García-Luján
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A. Suárez-Gauthier
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N. Mañes
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G. Renedo
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J.L. Duque-Medina
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E. García-Lagarto
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R. Rami-Porta
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G. González-Pont
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J. Astudillo-Pombo
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J.L. Maté-Sanz
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J. Freixinet
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T. Romero-Saavedra
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M. Sánchez-Céspedes
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A. Gómez de la Camara
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Abstract

The objective is to elaborate a survival model that integrates anatomic factors, according to the 2010 seventh edition of the tumour-node-metastasis (TNM) staging, with clinical and molecular factors.

Pathologic TNM-descriptors (Group A), clinical variables (Group B), laboratory parameters (Group C) and molecular markers [tissue microarrays] (Group D) were collected from 512 early NSCLC with complete resection. A multivariate analysis steped supervised learning classification algorithm was used.

The prognostic performance by groups is: areas under the ROC curve (C-index): 0.67 (Group A), 0.65 (Group B), 0.57 (Group C) and 0.65 (Group D). Considering together all variables selected for each of the 4 Groups (Integrated Group) the C-index was 0.74 (95%CI, 0.70–0.79), with statistically significant differences compared with each isolated group (from p=0.006 to p<0.001). Variables with the greatest prognostic discrimination are the presence of another ipsilobar nodule and tumour size >3 cm; followed by other anatomic and clinical factors; and molecular expressions of mammalian target of rapamycin (phospho-mTOR), Ki67cell proliferation index and p-Acetil-CoA-Carboxylase.

This study on early NSCLC shows the benefit from integrating pTNM, clinical and molecular factors into a composite prognostic model. The model of the Integrated Group classified patients with significantly higher accuracy compared to the TNM-2010 staging.

  • Ki67cell proliferation index
  • lung cancer
  • mammalian target of rapamycin (mTORp)
  • prognosis
  • staging
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    Composite anatomic-clinical-molecular prognostic model in non-small-cell lung cancer: a multicenter study of 512 patients
    A. López-Encuentra, F. López-Ríos, E. Conde, R. García-Luján, A. Suárez-Gauthier, N. Mañes, G. Renedo, J.L. Duque-Medina, E. García-Lagarto, R. Rami-Porta, G. González-Pont, J. Astudillo-Pombo, J.L. Maté-Sanz, J. Freixinet, T. Romero-Saavedra, M. Sánchez-Céspedes, A. Gómez de la Camara
    European Respiratory Journal Jan 2010, erj00286-2010; DOI: 10.1183/09031936.00028610

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    Composite anatomic-clinical-molecular prognostic model in non-small-cell lung cancer: a multicenter study of 512 patients
    A. López-Encuentra, F. López-Ríos, E. Conde, R. García-Luján, A. Suárez-Gauthier, N. Mañes, G. Renedo, J.L. Duque-Medina, E. García-Lagarto, R. Rami-Porta, G. González-Pont, J. Astudillo-Pombo, J.L. Maté-Sanz, J. Freixinet, T. Romero-Saavedra, M. Sánchez-Céspedes, A. Gómez de la Camara
    European Respiratory Journal Jan 2010, erj00286-2010; DOI: 10.1183/09031936.00028610
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