Prognostic Factors in Non-Small Cell Lung Cancer Less Than 3 Centimeters: Actuarial Analysis, Accumulative Incidence and Risk Groups

Abstract Introduction In TNM classification, factors determining the tumor (T) component in non-small cell lung cancer have scarcely changed over time and are still based solely on anatomical features. Our objective was to study the influence of these and other morphopathological factors on survival. Methods A total of 263 patients undergoing lung resection due to stage I non-small cell lung cancer ≤3 cm in diameter were studied. A survival analysis and competing-risk estimate study was made on the basis of clinical, surgical, and pathological variables using actuarial analysis and accumulative incidence methods, respectively. A risk model was then generated from the results. Results Survival at 5 and 10 years was 79.8 and 74.3%, respectively. The best prognostic factors were presence of symptoms, smoking habit and FEV1>60%, number of resected nodes>7, squamous histology, absence of vascular invasion, absence of visceral pleural invasion and presence of invasion more proximal than the lobar bronchus. All these were statistically significant according to the actuarial method. The factor “age 60%. Conclusions Pleural invasion and vascular invasion determine survival or risk of death due to non-small cell lung cancer ≤3 cm and can be used for generating a predictive risk model.