Original Articles
Non-small Cell Lung Cancer in Stage IA: Mortality Patterns After Surgery
J. Padilla
, J.C. Peñalver, C. Jordá, V. Calvo, J. Escrivá, J. Cerón, A. García Zarza, J. Pastor, E. Blasco
Corresponding author
jpadilla@comv.es
Correspondence: Dr. J. Padilla. Servicio de Cirugía Torácica. Hospital Universitario La Fe. Avda. de Campanar, 21. 46009 Valencia. España
Correspondence: Dr. J. Padilla. Servicio de Cirugía Torácica. Hospital Universitario La Fe. Avda. de Campanar, 21. 46009 Valencia. España
Servicio de Cirugía Torácica, Hospital Universitario La Fe, Valencia, Spain
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Blasco" "autores" => array:9 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "J." "apellidos" => "Padilla" "email" => array:1 [ 0 => "jpadilla@comv.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "J.C." "apellidos" => "Peñalver" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Jordá" ] 3 => array:2 [ "nombre" => "V." "apellidos" => "Calvo" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Escrivá" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Cerón" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "García Zarza" ] 7 => array:2 [ "nombre" => "J." "apellidos" => "Pastor" ] 8 => array:2 [ "nombre" => "E." "apellidos" => "Blasco" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cirugía Torácica, Hospital Universitario La Fe, Valencia, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J. Padilla. Servicio de Cirugía Torácica. Hospital Universitario La Fe. Avda. de Campanar, 21. 46009 Valencia. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-07-14" "fechaAceptado" => "2004-10-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec154009" "palabras" => array:5 [ 0 => "Bronchogenic carcinoma" 1 => "Stage IA" 2 => "Surgery" 3 => "Lymph node excision" 4 => "Mortality" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154010" "palabras" => array:5 [ 0 => "Carcinoma broncogénico" 1 => "Estadio IA" 2 => "Cirugía" 3 => "Disección ganglionar" 4 => "Patrón de mortalidad" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">TO determine the causes of death in patients treated surgically for nonsmall cell lung cancer (NSCLC) in stage IA and to evaluate the impact on survival of not performing systematic lymph node dissection and of the number of nodes resected.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">The study sample consisted of 156 patients operated on for NSCLC and classified in stage IA according to TNM staging. Only palpable or visible lymph nodes were dissected. Kaplan-Meier survival curves were compared using a log-rank test.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">At the end of the study, 85 (54.5%) patients had died, 67 (42.9%) were alive, and 4 (2.5%) were lost to follow up. Twenty-three (14.7%) died from a recurrence of NSCLC: 2 with local tumors (1.2%), 2 with mediastinal node involvement (1.2%), and 19 (12.1%) with distant metastasis. The cause of death was unrelated to NSCLC in 62 (39.7%) cases: 33 (21.1%) had a new tumor, 18 of which were bronchogenic, and 29 (18.5%) had nonmalignant disease. The 5-year survival rate was 81.4%. The rate was 88.9% among patients from whom no lymph nodes were excised and 79.9 % among those with node excision, although the difference was not statistically significant (<span class="elsevierStyleItalic">P</span> = .4073).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Our experience suggests that neither the fact of not performing systematic lymph node dissection nor the number of nodes resected has an impact on survival. A substantial number of patients died of causes unrelated to the NSCLC for which they had been treated.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Determinar las causas de mortalidad en los pacientes operados de un carcinoma broncogénico no anaplásico de células pequeñas (CBNACP) en estadio IA y el im-pacto que tiene en la supervivencia el hecho de no realizar una disección ganglionar sistemática, así como el número de ganglios resecados.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudió a 156 pacientes operados de un CBNACP y clasificados en el estadio IA de acuer-do con el sistema tumor, nódulo, metástasis patológico. Sólo se extirparon los ganglios palpables o visibles. La supervivencia se analizó con el método de Kaplan-Meier y las cur-vas se compararon mediante el test de rangos logarítmicos.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Al finalizar el estudio, 85 (54,5%) pacientes habían fallecido, 67 (42,9%) estaban vivos y 4 (2,5%) se ha-bían perdido en el seguimiento. Veintitrés (14,7%) pacientes fallecieron por recidiva del CBNACP: 2 por recidiva local (1,2%), otros 2 en el ganglio mediastínico (1,2%) y 19 (12,1%) por metástasis a distancia. En 62 (39,7%) de los casos la causa de la muerte no estuvo relacionada con el CBNACP: 33 (21,1%) fallecieron por aparición de un nuevo cáncer, 18 de los cuales fueron broncogénicos, y 29 (18,5%) por enfermeda-des no tumorales. La supervivencia a los 5 años fue del 81,4%. Cuando no se extirpó ningún ganglio, la supervivencia fue del 88,9%, mientras que cuando se extirparon fue del 79,9%, aunque la diferencia no fue significativa (p = 0,4073).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">En nuestra experiencia, ni el hecho de no realizar disección ganglionar sistemática ni el número de ganglios extirpados han tenido una influencia en la supervivencia a los 5 años. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 2 | 12 |
| 2024 October | 28 | 19 | 47 |
| 2024 September | 31 | 14 | 45 |
| 2024 August | 41 | 30 | 71 |
| 2024 July | 29 | 21 | 50 |
| 2024 June | 42 | 30 | 72 |
| 2024 May | 38 | 29 | 67 |
| 2024 April | 27 | 21 | 48 |
| 2024 March | 16 | 11 | 27 |
| 2024 February | 18 | 23 | 41 |
| 2023 April | 1 | 0 | 1 |
| 2023 March | 1 | 4 | 5 |
| 2023 February | 15 | 23 | 38 |
| 2023 January | 21 | 31 | 52 |
| 2022 December | 17 | 29 | 46 |
| 2022 November | 20 | 22 | 42 |
| 2022 October | 21 | 38 | 59 |
| 2022 September | 21 | 19 | 40 |
| 2022 August | 24 | 44 | 68 |
| 2022 July | 22 | 45 | 67 |
| 2022 June | 23 | 30 | 53 |
| 2022 May | 19 | 46 | 65 |
| 2022 April | 19 | 31 | 50 |
| 2022 March | 27 | 32 | 59 |
| 2022 February | 16 | 27 | 43 |
| 2022 January | 20 | 34 | 54 |
| 2021 December | 18 | 41 | 59 |
| 2021 November | 25 | 42 | 67 |
| 2021 October | 20 | 45 | 65 |
| 2021 September | 14 | 42 | 56 |
| 2021 August | 15 | 38 | 53 |
| 2021 July | 15 | 30 | 45 |
| 2021 June | 14 | 34 | 48 |
| 2021 May | 18 | 32 | 50 |
| 2021 April | 21 | 52 | 73 |
| 2021 March | 24 | 27 | 51 |
| 2021 February | 15 | 30 | 45 |
| 2021 January | 8 | 14 | 22 |
| 2020 December | 12 | 16 | 28 |
| 2020 November | 11 | 19 | 30 |
| 2020 October | 4 | 14 | 18 |
| 2020 September | 9 | 8 | 17 |
| 2020 August | 10 | 12 | 22 |
| 2020 July | 18 | 23 | 41 |
| 2020 June | 7 | 8 | 15 |
| 2020 May | 24 | 20 | 44 |
| 2020 April | 15 | 11 | 26 |
| 2020 March | 20 | 16 | 36 |
| 2020 February | 24 | 18 | 42 |
| 2020 January | 19 | 12 | 31 |
| 2019 December | 7 | 14 | 21 |
| 2019 November | 8 | 12 | 20 |
| 2019 October | 8 | 7 | 15 |
| 2019 September | 11 | 5 | 16 |
| 2019 August | 11 | 12 | 23 |
| 2019 July | 11 | 14 | 25 |
| 2019 June | 12 | 7 | 19 |
| 2019 May | 17 | 9 | 26 |
| 2019 April | 10 | 13 | 23 |
| 2019 March | 19 | 22 | 41 |
| 2019 February | 14 | 10 | 24 |
| 2019 January | 7 | 8 | 15 |
| 2018 December | 7 | 13 | 20 |
| 2018 November | 13 | 10 | 23 |
| 2018 October | 15 | 15 | 30 |
| 2018 September | 12 | 5 | 17 |
| 2018 May | 4 | 0 | 4 |
| 2018 April | 5 | 5 | 10 |
| 2018 March | 3 | 3 | 6 |
| 2018 February | 5 | 7 | 12 |
| 2018 January | 2 | 7 | 9 |
| 2017 December | 4 | 6 | 10 |
| 2017 November | 5 | 7 | 12 |
| 2017 October | 3 | 9 | 12 |
| 2017 September | 3 | 12 | 15 |
| 2017 August | 8 | 8 | 16 |
| 2017 July | 1 | 3 | 4 |
| 2017 June | 9 | 24 | 33 |
| 2017 May | 5 | 7 | 12 |
| 2017 April | 1 | 2 | 3 |
| 2017 March | 3 | 5 | 8 |
| 2017 February | 3 | 9 | 12 |
| 2017 January | 2 | 9 | 11 |
| 2016 December | 9 | 7 | 16 |
| 2016 November | 12 | 7 | 19 |
| 2016 October | 11 | 8 | 19 |
| 2016 September | 10 | 10 | 20 |
| 2016 August | 6 | 5 | 11 |
| 2016 July | 2 | 7 | 9 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 80 | 1 | 81 |
| 2015 September | 74 | 10 | 84 |
| 2015 August | 61 | 8 | 69 |
| 2015 July | 67 | 9 | 76 |
| 2015 June | 47 | 6 | 53 |
| 2015 May | 47 | 16 | 63 |
| 2015 April | 59 | 11 | 70 |
| 2015 March | 65 | 6 | 71 |
| 2015 February | 46 | 3 | 49 |
| 2015 January | 53 | 7 | 60 |
| 2014 December | 82 | 5 | 87 |
| 2014 November | 89 | 5 | 94 |
| 2014 October | 65 | 8 | 73 |
| 2014 September | 45 | 7 | 52 |
| 2014 August | 68 | 9 | 77 |
| 2014 July | 71 | 7 | 78 |
| 2014 June | 87 | 10 | 97 |
| 2014 May | 83 | 9 | 92 |
| 2014 April | 46 | 4 | 50 |
| 2014 March | 62 | 7 | 69 |
| 2014 February | 55 | 8 | 63 |
| 2014 January | 65 | 8 | 73 |
| 2013 December | 30 | 9 | 39 |
| 2013 November | 34 | 6 | 40 |
| 2013 October | 42 | 4 | 46 |
| 2013 September | 40 | 12 | 52 |
| 2013 August | 27 | 8 | 35 |
| 2013 July | 42 | 10 | 52 |
| 2013 June | 27 | 7 | 34 |
| 2013 May | 30 | 5 | 35 |
| 2013 April | 25 | 6 | 31 |
| 2013 March | 6 | 2 | 8 |
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