PT  - JOURNAL ARTICLE
AU  - A. López-Encuentra
AU  - F. López-Ríos
AU  - E. Conde
AU  - R. García-Luján
AU  - A. Suárez-Gauthier
AU  - N. Mañes
AU  - G. Renedo
AU  - J.L. Duque-Medina
AU  - E. García-Lagarto
AU  - R. Rami-Porta
AU  - G. González-Pont
AU  - J. Astudillo-Pombo
AU  - J.L. Maté-Sanz
AU  - J. Freixinet
AU  - T. Romero-Saavedra
AU  - M. Sánchez-Céspedes
AU  - A. Gómez de la Camara
AU  - on behalf of the Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCB-S)
TI  - Composite anatomic-clinical-molecular prognostic model in non-small-cell lung cancer: a multicenter study of 512 patients
AID  - 10.1183/09031936.00028610
DP  - 2010 Jan 01
TA  - European Respiratory Journal
PG  - erj00286-2010
4099  - http://erj.ersjournals.com/content/early/2010/08/20/09031936.00028610.short
4100  - http://erj.ersjournals.com/content/early/2010/08/20/09031936.00028610.full
AB  - 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.