The value of tumor volume in surgically resected non-small cell lung cancer.
BACKGROUND
The aim of this study was to evaluate whether or not tumor volume (TV) has an impact on survival in non-small cell lung cancer.


METHODS
In a retrospective analysis of 385 cases with NSCLC who underwent curative surgery between 1994 and 2003, we calculated the tumor volume by using an ellipsoidal formula. The patients were grouped according to TV as determined by histograms. Gender, age, histology, nodal involvement, size, and TV were analyzed. Multivariate analysis by Cox's proportional hazards regression model was performed to identify the prognosis.


RESULTS
Cases of N0 showed a significantly lower TV than cases with other N statuses (p < 0.05). A significant difference was also observed between TV and histology or gender. The 189 patients belonging to the small volume group (SVG) (range, 0.105 to 9.265 cm3) had a significantly better overall survival rate than the other 196 patients in the large volume group (LVG) (9.266-366.522 cm3). With univariate analysis, gender, age, nodal involvement, size, and TV were significantly associated with prognosis. Multivariate analysis showed that only gender (p = 0.0184) and nodal involvement (p = 0.0001) were significantly independent prognostic factors. The size factor was not significant (p = 0.5285). However, TV was not an independent factor, but trending toward significance (p = 0.0801).


CONCLUSIONS
Although TV provides no independent prognostic information with multivariate analysis, TV in NSCLC should be considered using volumetric measurement with a three-dimensional CT approach prior to surgery or treatment planning.
Second Department of Surgery, School of Medicine, Fukuoka University, Jonan-ku, Fukuoka, Japan. akinori@fukuoka-u.ac.jp
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A
Iwasaki
T
T
Shirakusa
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Enatsu
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S
Maekawa
T
T
Hamada
M
M
Hamasaki
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008962:Models, Theoretical; D009367:Neoplasm Staging / Q000379:methods; D011013:Pneumonectomy; D011379:Prognosis; D012189:Retrospective Studies