title: [Mortality in early-stage, surgically resected non-small cell lung cancer less than 3 cm of size: Competing risk analysis].
abstract: OBJECTIVE
  Survival studies of non-small cell lung cancer (NSCLC) are usually based on the Kaplan-Meier method. However, other factors not covered by this method may modify the observation of the event of interest. There are models of cumulative incidence (CI), that take into account these competing risks, enabling more accurate survival estimates and evaluation of the risk of death from other causes. We aimed to evaluate these models in resected early-stage NSCLC patients.
  
  
  METHODS
  This study included 263 patients with resected NSCLC whose diameter was ≤ 3 cm without node involvement (N0). Demographic, clinical, morphopathological and surgical variables, TNM classification and long-term evolution were analysed. To analyse CI, death by another cause was considered to be competitive event. For the univariate analysis, Gray's method was used, while Fine and Gray's method was employed for the multivariate analysis.
  
  
  RESULTS
  Mortality by NSCLC was 19.4% at 5 years and 14.3% by another cause. Both curves crossed at 6.3 years, and probability of death by another cause became greater from this point. In multivariate analysis, cancer mortality was conditioned by visceral pleural invasion (VPI) (P=.001) and vascular invasion (P=.020), with age>50 years (P=.034), smoking (P=.009) and the Charlson index ≥ 2 (P=.000) being by no cancer.
  
  
  CONCLUSIONS
  By the method of CI, VPI and vascular invasion conditioned cancer death in NSCLC >3 cm, while non-tumor causes of long-term death were determined.
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Jordá Aragón
authors.affiliation: Servicio de Cirugía Torácica, Instituto Valenciano de Oncología, Valencia, España.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Peñalver Cuesta
authors.affiliation: Servicio de Anatomía Patológica, Hospital Universitario y Politécnico La Fe, Departamento de Patología, Universidad de Valencia, Valencia, España.
authors.forename: Nuria
authors.initials: N
authors.lastname: Mancheño Franch
authors.affiliation: Servicio de Cirugía Torácica, Instituto Valenciano de Oncología, Valencia, España.
authors.forename: Karol
authors.initials: K
authors.lastname: de Aguiar Quevedo
authors.affiliation: Servicio de Anatomía Patológica, Hospital Universitario y Politécnico La Fe, Departamento de Patología, Universidad de Valencia, Valencia, España.
authors.forename: Francisco
authors.initials: F
authors.lastname: Vera Sempere
authors.affiliation: Servicio de Cirugía Torácica, Instituto Valenciano de Oncología, Valencia, España. Electronic address: jpadilla@comv.es.
authors.forename: José
authors.initials: J
authors.lastname: Padilla Alarcón
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D002423:Cause of Death; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011013:Pneumonectomy; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013147:Spirometry; D047368:Tumor Burden
keywords: Análisis de riesgos competitivos; Carcinoma pulmonar; Cirugía; Competing risks analysis; Non-small cell lung cancer; Supervivencia; Surgery; Survival