|Lung cancer staging: a physiological update.|
|PMID: 22419795 Owner: NLM Status: MEDLINE|
|The tumour-node metastasis (TNM) classification system is anatomically based. We investigated whether the addition of simple physiological variables, age and body mass index (BMI), would affect survival curves, i.e. a composite anatomical and physiological staging system. We retrospectively analysed a prospectively validated thoracic surgery database (n = 1981). Cox multivariate analysis was performed to determine possible significant factors. Kaplan-Meier survival curves were constructed with combined anatomical and physiological factors. Cox multivariate analysis revealed age (P < 0.001) and BMI (P = 0.01) as significant factors affecting survival. Receiver operating curve analysis determined cut-off levels for age of 67 and BMI of 27.6. A composite anatomical and physiological survival curve based on TNM for BMI > 27.6 and age < 67 was produced. Age and BMI criteria resulted in significantly different survival curves, for stage I (P < 0.0001) and stage II (P = 0.0032), but not for stage III (P = 0.06). Neural network analysis confirmed the importance of BMI and age above cancer stage with regard to long-term survival. Combining age < 67, BMI > 27.6 and TNM anatomical classification results in very different estimated survival curves from the usual TNM system. Patients from stages I, II and III may have survival equivalent to a stage higher or lower depending on their age and BMI.|
|Michael Poullis; James McShane; Mathew Shaw; Steven Woolley; Michael Shackcloth; Richard Page; Neeraj Mediratta|
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|Type: Journal Article Date: 2012-03-14|
|Title: Interactive cardiovascular and thoracic surgery Volume: 14 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2012 Jun|
|Created Date: 2012-05-16 Completed Date: 2012-09-07 Revised Date: 2013-06-26|
Medline Journal Info:
|Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England|
|Languages: eng Pagination: 743-9 Citation Subset: IM|
|Liverpool Heart and Chest Hospital, Liverpool, UK. firstname.lastname@example.org|
|APA/MLA Format Download EndNote Download BibTex|
Body Mass Index
Lung Neoplasms / mortality, pathology*, physiopathology, therapy
Lymph Nodes / pathology
Neoplasm Staging / methods*
Neural Networks (Computer)
Predictive Value of Tests
Proportional Hazards Models
Tomography, X-Ray Computed
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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