Objective: To evaluate the effect of comorbidity as an independent prognostic factor in lung cancer.
Method: Data on 2991 consecutive cases of lung cancer were collected 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 effect of comorbidity on survival, 1121 patients with non-small cell lung cancer (NSCLC) in pathological stage I who underwent complete resection were selected, excluding operative mortality. The presence of specific comorbidities at the time of thoracotomy was registered prospectively.
Results: Cox regression analysis showed that tumour size (0–2, 2–4, 4–7, >7 cm) (HR 1.45 95% CI 1.08 to 1.95), 1.86 (95% CI 1.38 to 2.51), 2.84 (95% CI 1.98 to 4.08)), the presence of a previous tumour (HR 1.45 (95% CI 1.17 to 1.79)) and age (HR 1.02 (95% CI 1.01 to 1.03)) had a significant prognostic association with survival. This study excluded the presence of visceral pleural involvement or other comorbidities as independent variables.
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 by 1.5 times at 5 years. It is independent of other comorbidities, TNM classification and age.
- BMI, body mass index
- COPD, chronic obstructive pulmonary disease
- GCCB-S, Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery
- NSCLC, non-small cell lung cancer
- SCLC, small-cell lung cancer
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Published Online First 31 January 2006
This study was partly financed by FIS grant 97/0011, FEPAR-2000 grant, RTIC-03/11-ISCIII-Red-Respira grant, RTIC-03/090-ISCIII-Red MBE, FIS grant 03/46 and financial aid from Castilla-León regional government and Menarini Foundation. None of the supporting organisations participated in the study design or in analysis of the data or its interpretation. The authors had full access to all the data in the study and were ultimately responsible for submitting the paper for publication.
Competing interests: None.
A complete list of GCCB-S members is given in Appendix A.
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