Impact of tumor size on survival in stage IA non-small cell lung cancer: a case for subdividing stage IA disease

Purpose: Stage IA (T1N0M0) non-small cell lung cancer (NSCLC) includes lesions up to 3 cm in diameter. With the use of advanced imaging techniques, pulmonary lesions can be identified. A greater proportion of patients with NSCLC likely have smaller tumors at presentation in the future. The purpose of this study to determine the relationship between tumor size, and survival in patients pathologic stage IA NSCLC. Methods: We conducted a retrospective review of consecutive, surgically treated patients with pathologic stage IA NSCLC. patients were identified from the tumor registries and pathology records. was obtained from the surgical database and primary physicians' records. Results: Eighty six patients had tumors less than or equal to 1.5 cm while 160 patients had tumors 1.6-3.0 cm. The median follow-up time is 60 months. The patients with the tumors less than or equal to 1.5 cm an improved outcome when compared with patients with tumors 1.6-3.0 cm. The year disease free survival (DFS) was 81.5 and 70.9%, respectively, (P = 0.03) and 5-year overall survival was 85.5 and 78.6%, respectively (P = 0.05). In the analysis, tumor size was an independent prognostic factor for survival. Conclusions: Tumor size is a prognostic factor in pathologic stage IA NSCLC treated with surgical resection. Such improvement, not observed in some earlier reports, represent the effect of improved imaging and pre-operative surgical techniques. finding requires confirmation in prospective series, but is important since it makes case for further subdividing T1 lesions in resected NSCLC. (C) 2003 Elsevier Ireland Ltd. All rights reserved.