Chest
Clinical InvestigationsLUNG CANCERTumor Size Predicts Survival Within Stage IA Non-Small Cell Lung Cancer*
Section snippets
Patients and Methods
We conducted a retrospective chart review of all patients with NSCLC surgically treated at our institution between January 1990 and December 2001. All patients with completely resected pathologic stage IA NSCLC were identified. Hospital and office records were examined for demographic and pathologic data including age, gender, histology, and tumor size. Tumor size was categorized around the value of 2 cm.
Univariate associations between tumor size category and other prognostic factors were
Results
Patient characteristics are presented in Table 1. Two hundred forty-four patients were studied. Twenty-two patients had their tumor detected as part of an ongoing CT screening program. All patients underwent a complete mediastinal lymph node dissection at the time of thoracotomy. Median follow-up for all patients was 31 months. Tumor size distribution is illustrated in Figure 1. The overall 5-year survival was 71.1% (95% confidence interval [CI], 63.6 to 78.6%) [Fig 2]. Forty-nine patients had
Discussion
The current lung cancer staging system clearly recognizes a difference in survival between tumors < 3 cm and those > 3 cm. This distinction is well supported by several retrospective studies23456 that have shown a survival advantage for stage I patients with T1 tumors vs T2 tumors. However, there is conflicting evidence to support the impact of size as a determinant of outcome when only tumors < 3 cm in size are considered. This issue has important implications for lung cancer screening as well
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