Jassem J, Skokowski J, Dziadziuszko R, Jassem E, Szymanowska A, Rzyman W, Roszkiewicz A
Departments of Oncology and Radiotherapy, Thoracic Surgery, Pneumonology, and Pathology, Medical University of Gdańsk, Poland.
J Thorac Cardiovasc Surg. 2000 Jun;119(6):1141-6. doi: 10.1067/mtc.2000.105825.
Prognostic relevance of the current TNM stage grouping for lung cancer is still a matter of debate.
To validate the new pathologic TNM classification for non-small cell lung cancer, we analyzed the survival data of 586 patients who underwent complete pulmonary resection and pathologic staging at one institution.
The current TNM stage grouping well reflected the long-term prognostic hierarchy. There was a good distinction between new substages IA and IB (5-year survivals of 66% and 53%, respectively). The subdivision of stage II led to an under-representation of stage IIA (6 patients [1.0%]), and therefore the appropriateness of this modification could not be verified. Five-year survival in the T3 N0 category (30%) was significantly better than that found in the new stage IIIA (15%). No difference was found between T3 N0 and T2 N1, the categories constituting new stage IIB. Within stage IIIA there was a significant survival difference between T3 N2 (6%) and the remaining T and N designations (18%). Moreover, the 5-year survival in the T3 N1 category (35%) was similar to that found in the new stage IIB (27%) and better than in any T N2 tumors (12%).
Most of our findings confirmed prognostic relevance of the current pTNM stage grouping in patients with resectable non-small cell lung cancer. However, despite recent modifications, there is still a significant heterogeneity that flaws stage IIIA.
目前肺癌TNM分期分组的预后相关性仍存在争议。
为验证非小细胞肺癌新的病理TNM分类，我们分析了在一家机构接受完整肺切除和病理分期的586例患者的生存数据。
目前的TNM分期分组很好地反映了长期预后层次。新的IA期和IB期之间有明显差异（5年生存率分别为66%和53%）。II期的细分导致IIA期代表性不足（6例[1.0%]），因此无法验证这种修改的适当性。T3N0组的5年生存率（30%）明显高于新的IIIA期（15%）。构成新IIB期的T3N0和T2N1组之间未发现差异。在IIIA期内，T3N2组（6%）与其余T和N分类（18%）之间存在显著的生存差异。此外，T3N1组的5年生存率（35%）与新IIB期（27%）相似，且优于任何T N2肿瘤（12%）。
我们的大多数研究结果证实了目前pTNM分期分组对可切除非小细胞肺癌患者的预后相关性。然而，尽管最近进行了修改，但IIIA期仍存在显著的异质性缺陷。
