Clinical stage change in nonmicrocyst pulmonary cancer

INTRODUCTION. Change of clinical stage of non-microcyst pulmonary cancer in comparing the pre-postoperative and postoperative periods may to have negative repercussions on the definition of therapeutical strategies. The aim of present paper was to assess the magnitude of such changes and its effect on the patient. METHODS. A retrospective study was conducted with a prospective database of 259 patients treated from January, 2002 to December, 2007. Patients with neoadjuvant therapy, palliative interventions or relapse and small cells neoplasms were excluded. The study variables were: tumor factors (T), nodules (N) and metastasis (M), tumor position and location and involved lung. Agreement coefficient allowed assessing the change magnitude and the Chi test, the association between the two variables. RESULTS. T factor changed in 91 patients (35,1%) more frequent in superior lobules lesions (p = 0,04). Position wasn't associated with the change (p = 0,110). N factor was modified in 50 cases (19,3%). Associated with change were: lobular location (p = 0,001), involved lung (p = 0,002) and T factor (p = 0,013). The change in T factor happened in 11 patients (4,2%) and wasn't associated with the position (p = 0,120), location (p = 0,225) or T factor (p = 0,339). Agreement coefficient was low (κ = 0,381; p < 0,001), because of the change occurred in the 49,03% of patients. CONCLUSIONS. The change in clinical stage was of a significant magnitude and thus, has the potential to induce to inappropriate medical and surgical treatments practice.