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Vol. 37. Issue 1.
Pages 19-26 (January 2001)
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Vol. 37. Issue 1.
Pages 19-26 (January 2001)
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Supervivencia posquirúrgica en el estadio II del carcinoma broncogénico no anaplásico de células pequeñas
Postoperative survival in stage II non-small cell bronchogenic carcinoma
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V. Calvo Medina
Corresponding author
vjcalvo@comv.es

Correspondencia: Servicio de Cirugía Torácica. Hospital Universitario La Fe Avda. Campanar, 21. 46009 Valencia.
, J. Padilla Alarcón, F. París Romeu, E. Blasco Armengod, J. Pastor Guillem, A. García Zarza
Servicio de Cirugía Torácica. Hospital Universitario La Fe. Valencia
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Objetivo

El presente trabajo trata de validar en nuestra población las modificaciones del estadio II del nuevo sistema de estadificación del carcinoma broncogénico no anaplásico de células pequeñas.

Pacientes Y Métodos

Revisamos retrospectivamente y seguimos en su evolución a 336 pacientes operados con re-sección completa en nuestro hospital desde enero de 1969 a diciembre de 1995, con estadio II patológico y distribuidos como T1N1M0 (41), T2N1M0 (144) y T3N0M0 (151).

Resultados

La supervivencia esperada en nuestra pobla-ción fue de 43,19 ± 2,90% a los 5 años. La estimación de la mediana fue de 3 ± 0,71 años (intervalo de confianza [IC] del 95%, 1,60-4,40). El tiempo medio de supervivencia fue de 8,82 ± 0,67 años (IC del 95%, 7,51-10,13). Los tumores clasi-ficados como T1N1M0 presentaron una supervivencia del 53,32 ± 8,55% a los 5 años; en los T2N1M0 el porcentaje fue del 38,57 ± 4,40%, y en los T3N0M0 fue del 44,46 ± 4,30%.

Encontramos diferencias significativas entre superviven-cias en función del tipo histológico, tamaño tumoral, estadio II A o II B, grado de invasión tumoral (T), número de gan-glios afectados (N 1 ) y localización de los mismos. Los tumo-res clasificados como T3N0M0 presentaron una amplia varia-bilidad en los porcentajes esperados de supervivencia a los 5 años en función de las estructuras afectadas (27,53 a 59,98%). Un análisis multivariante confirmó como principa-les factores pronósticos el grado de invasión tumoral, el ta-maño tumoral y el tipo histológico.

Conclusiones

El nuevo sistema de estadificación está más cerca de la realidad pronóstica de los pacientes en nues-tra población. La división en estadio II A y II B es adecuada y presenta diferencias pronósticas significativas. Sin embar-go, el apartado T3N0M0 es heterogéneo y no presenta dife-rencias significativas respecto al T1-2N1M0 , por lo que el esta-dio II, en conjunto, continúa sin estar configurado por un grupo homogéneo de pacientes. Otras variables pronósticas, como el tipo histológico, condicionaron la supervivencia en nuestra población.

Palabras clave:
Cáncer de pulmón
Estadio II
Supervivencia
Objective

This study aimed to validate in our popula-tion changes in the stage II criteria for non-small cell bron-chogenic carcinoma.

Patients And Methods

We retrospectively reviewed and followed the course of disease in 336 patients who under-went complete resection in our hospital between January 1969 and December 1995 with stage II disease, classified as T1N1M0 (41), T2N1M0 (144) and T3N0M0 (151).

Results

The expected five-year survival in our popula-tion was 43.19 ± 2.90%. Estimated mean survival was 3 ± 0.71 years (95% confidence interval: 1.60-4.40). Mean survi-val was 8.82 ± 0.67 years (95% confidence interval 7.51-10.13). Five-year survival was 53.32 ± 8.55% for tumors classified as T1N1M0 , 38.57 ± 4.40% for T2N1M0 , and 44.46 ± 4.30% for T3N0M0.

We observed significant differences in survival depending on histological type, tumor size, and IIA or IIB staging, de-gree of tumor invasion (T), number of nodes involved (N 1 ) and location. T3N0M0 tumors displayed great variation in expected survival rates in relation to structures involved (27.53% to 59.98%). Multivariate analysis confirmed degree of tumor invasion, size and histological type to be the main prognostic factors.

Conclusions

We conclude that the new staging system gives a more realistic prognosis for patients in our practice. The stage IIA and IIB division is appropriate and gives sig-nificantly different prognoses. However, the T3N0M0 cate-gory is heterogeneous and is not significantly different from T1-2N1M0 , such that stage II overall continues to be an indivi-sible, homogeneous group of patients. Other prognostic va-riables, such as histological type, affect survival in our pa-tients.

Keywords:
Lung cancer
Stage II
Survival
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