Revisit of 1997 TNM staging system--survival analysis of 1112 lung cancer patients in Taiwan.
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.
Perng
Reury-Perng
RP
Chest Department, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
Chen
Chih-Yi
CY
Chang
Gee-Chen
GC
Hsia
Te-Chun
TC
Hsu
Nan-Yung
NY
Tsai
Ying-Huang
YH
Tsai
Chun-Ming
CM
Yang
Chih-Hsin
CH
Chen
Yuh-Min
YM
Yu
Chong-Jen
CJ
Lee
Jen-Jyh
JJ
Hsu
Han-Shui
HS
Yu
Chih-Teng
CT
Kao
Eing-Long
EL
Chiu
Chao-Hua
CH
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