Previous tumour is a prognostic factor in stage I non-small cell lung cancer

Angel López-Encuentra ^1*, Agustín Gómez de la Cámara ¹, Ramón Rami-Porta ², José Luis Duque-Medina ³, José Luis Martín de Nicolás ¹ and Javier Sayas ¹

¹ Hospital Universitario 12 de Octubre, Spain
² Hospital Mutua de Terrassa, Spain
³ Hospital Clínico Universiatario Valladolid, Spain

^* To whom correspondence should be addressed. E-mail: lencuent{at}h12o.es.

Accepted 23 January 2006

Abstract

Objective: To evaluate the presence of co-morbidity as an independent prognostic factor in lung cancer.

Population and methods: Data on 2,991 consecutive cases of lung cancer was gathered prospectively from 19 Spanish hospitals between 1993 and 1997 by the Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCB-S). To evaluate the survival impact due to the existence of co-morbidity, 1,121 cases of non-small-cell lung cancer (NSCLC) in pathological stage I with complete resection were selected, excluding operative mortality. At the time of thoracotomy, the presence of specific co-morbidities was registered prospectively.

Results: In Cox regression, strata of tumoral size (0-2, 2-4, 4-7, >7 cm) (HR 1.45 [95% confidence intervals (95% CI) 1.08-1.95], 1.86 [95% CI 1.38-2.51], 2.84 [95% CI 1.98-4.08]), previous tumour (present - absent) (HR 1.45 [95% CI 1.17-1.79]) and age (HR 1.02 [95% CI 1.01-1.03]) showed a significant prognostic association with survival. These study exclude the presence of visceral pleural involvement or other co-morbidities as an independent variable.

Conclusion: The presence of a previous tumour is an independent prognostic factor in pathological stage I NSCLC with complete resection, increasing the probability of death 1.5 times at 5 years. It is independent from other co-morbidities, TNM classification and age.

Keywords: comorbidity, lung cancer, prospective studies, staging, surgery

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