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. 2013 May 16:6:539-47.
doi: 10.2147/OTT.S44201. Print 2013.

New dilemmas in small-cell lung cancer TNM clinical staging

Konstantinos Zarogoulidis  1 , Dimitrios Latsios, Konstantinos Porpodis, Paul Zarogoulidis, Kaid Darwiche, Nick Antoniou, Wolfgang Hohenforst-Schmidt, Ellada Eleftheriadou, Efimia Boutsikou, Theodoros Kontakiotis
Affiliations

New dilemmas in small-cell lung cancer TNM clinical staging

Konstantinos Zarogoulidis et al. Onco Targets Ther. .

Abstract

Background: Many patients with limited disease (LD) behave similarly to those with extensive disease (ED) from a prognostic point of view. On the other hand, a proportion of patients with ED small-cell lung cancer (SCLC) behave similarly to those with LD.

Patients and methods: In this retrospective study analysis, 764 patients with proven SCLC were included and managed with the same therapeutic protocols. Of these patients, 278 (36.4%) had LD, while 486 (63.6%) had ED.

Results: No statistically significant difference was observed for survival for IA and IB disease stages (P = 0.254) and between IIA and IIB stages (P = 0.256) according to the new tumor, node, metastasis (TNM) staging classification classification. In addition, no statistical significant difference was observed for survival between patients with (IIA + IIB) and IIIA (P = 0.951), (IIA + IIIA, P = 0.658), and (IIB + IIIA, P = 0.573) stages. Statistical significant difference was observed for survival among the LD SCLC patients with (IA + IB), (IIA + IIB + IIIA), and IIIB stages (P < 0.001). Similarly, statistical significance was observed for ED SCLC patients with (IIA + IIB + IIIA), IIIB, and IV stages (P < 0.001).

Conclusions: Although stratification of SCLC patients in LD and ED is generally satisfactory, the TNM staging system is recommended for more detailed prognostic information and treatment evaluation in these patients.

Keywords: lung cancer; small-cell lung cancer; staging.

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Figures

Figure 1
Figure 1
Survival analysis of proposed small cell lung cancer system (A) Survival analysis by disease stage, according to the 7th edition of the IASLC TNM staging system, (B) Survival analysis by disease stage, (C) Survival analysis by disease stage, (D) Survival analysis by single metastatic site. Abbreviations: IASLC, International Association for the Study of Lung Cancer; TNM, tumor, node, metastasis.
See this image and copyright information in PMC

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