title: Revisit of 1997 TNM staging system--survival analysis of 1112 lung cancer patients in Taiwan.
abstract: BACKGROUND
  There is neither a nation-wide nor a large-scale, multi-institutional lung cancer database available for stage-by-stage survival analysis in Taiwan at present.
  
  
  METHODS
  Using the data element provided by the International Association for the Study of Lung Cancer, the Taiwan Lung Cancer Society initiated a project to include native lung cancer patients into a global database. A total of 1112 Taiwan lung cancer patients treated in 7 medical centers were enrolled.
  
  
  RESULTS
  In small cell lung cancer, patients with ipsilateral pleural effusion had a survival between those with locoregional disease alone and those with distant metastasis; however, the difference was not statistically significant (P = 0.204). In non-small cell lung cancer, tumor size had significant survival influence for patients as a whole (P < 0.001) but it did not support the further division of stage IA according to tumor size (P = 0.122). The survival was compatible in stage IIIB and IV patients and therefore, the survival impact of pleural effusion cannot be determined. In patients with pIIIA-N2 disease, those who had station 8 nodal metastasis had inferior survival (P = 0.020) and station 5 superior survival (P = 0.010). In patients with distant metastasis, bone, liver, or distant lymph node metastasis predicted an inferior survival (all P values < 0.05).
  
  
  CONCLUSIONS
  The present study provides for comparison in this area a stage-by-stage reference for the survival of lung cancer patients. Some factors other than current TNM descriptors need to be further investigated in constructing the next version of the staging system.
authors.affiliation: Chest Department, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Reury-Perng
authors.initials: RP
authors.lastname: Perng
authors.forename: Chih-Yi
authors.initials: CY
authors.lastname: Chen
authors.forename: Gee-Chen
authors.initials: GC
authors.lastname: Chang
authors.forename: Te-Chun
authors.initials: TC
authors.lastname: Hsia
authors.forename: Nan-Yung
authors.initials: NY
authors.lastname: Hsu
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Tsai
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Yang
authors.forename: Yuh-Min
authors.initials: YM
authors.lastname: Chen
authors.forename: Chong-Jen
authors.initials: CJ
authors.lastname: Yu
authors.forename: Jen-Jyh
authors.initials: JJ
authors.lastname: Lee
authors.forename: Han-Shui
authors.initials: HS
authors.lastname: Hsu
authors.forename: Chih-Teng
authors.initials: CT
authors.lastname: Yu
authors.forename: Eing-Long
authors.initials: EL
authors.lastname: Kao
authors.forename: Chao-Hua
authors.initials: CH
authors.lastname: Chiu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016019:Survival Analysis; D013624:Taiwan