[Application of the 2007 lung cancer staging system by International Association for the Study of Lung Cancer].
OBJECTIVE
To compare the prognoses of non-small cell lung cancer patients based respectively on the 6th-Edition Staging System for NSCLC (the 6th-Edition Staging System) and the new staging system by the International Association for the Study of Lung Cancer (IASLC) (new staging system).


METHODS
Data were collected from 136 operated NSCLC patients from Sep. 2003 through Oct. 2007. Those data were staged based respectively on the 6th-Edition Staging System and the new staging system. The 2-year no-recurrence survival rate was calculated, and life span was analyzed using the Kaplan-Meier method of SPSS 13.0 software.


RESULTS
(1) In this series, using the 6th-Edition Staging System, there were 56, 23, 53 and 4 patients in stage I, stage II, stage III and stage IV respectively; using the new staging system, there were 50, 31, 54 and 1 patients in stage I, stage II, stage III and stage IV respectively. There were 6 patients in stage I according to the 6th-Edition Staging System who had become 6 patients in stage II according to the new staging system, 1 patient in stage II 1 in stage III, 3 patients in stage III 3 in stage II, 1 patient in stage III 1 in stage IV, and 4 patients in stage IV 4 in stage III. (2) According to the 6th-Edition Staging System, the 2-year no-recurrence survival rates for Ia, Ib, IIa, IIb,IIIa, IIIb and IV were 95.0%, 83.3%, 100.0%, 63.6%, 52.1%, 80.0% and 50.0% respectively, and according to the new staging system, the 2-year cumulative survival rates for I a, Ib, IIa, IIb, IIIa, IIIb and IV were 95.5%, 89.3%, 68.4%, 63.6%, 52.8%, 50.0% and 0.0% respectively. After Chi square analysis, there was no distinguished difference between the 2 staging systems for the 2-year cumulative survival rate. (3) According to the 6th-Edition Staging System, the difference between the no-recurrence rate of stage I and stage II was not statistically significant (P = 0.232), and the difference between the no-recurrence rates of stage II and III was statistically significant(P = 0.023); according to the new staging system, the difference between the no-recurrence rates of stage I and stage II as well as between those of stage II and stage III were both statistically significant (P = 0.023 and 0.014 respectively). (4) The differences between the no-recurrence rates of the patients on the two sides, above and below the tumor maximum diameter cutpoint 2 cm, as well as the cutpoint 5 cm were statistically significant (P = 0.025; P = 0.023).


CONCLUSIONS
The new staging system by NSCLC has better staging specificity than the 6th-Edition Staging System and could be used for Chinese patients.
Wang
Jia
J
Department of Thoracic Surgery, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100412, China.
Wu
Nan
N
Zheng
Qing-feng
QF
Feng
Yuan
Y
Yan
Shi
S
Yang
Yue
Y
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000145:classification / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007391:International Cooperation; D008175:Lung Neoplasms / Q000145:classification / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000592:standards*; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D016019:Survival Analysis