The relationship between tumor size in non-small cell lung cancer and stage distribution remains controversial. The current study is to assess relationship between tumor size and disease stage distribution at the time of diagnosis.
A retrospective analysis of the clinicopathologic records of total of 917 cases with surgically treated for NSCLC in Fudan University Cancer Hospital and Shanghai sixth hospital between January 2000 and February 2009 was conduced. The tumor size was grouped into five categories: < 15 mm; 16–25 mm, 26–35 mm, 36–45 mm and > 46 mm. Univariate associations between the category variables were explored by logistic regression.
A total of 917 patients (women (72.2%); and men (27.8%)) with NSCLC met the inclusive criteria were analyzed. The distribution of the five categories: 9.8% with lesions < 15 mm; 19.0% with lesions 16–25 mm; 21.3% with lesions 26–35 mm; 16.7% with lesions 36–45 mm and 33.3% with lesions > 46 mm. Univariate and multivariate analysis revealed that tumor size affected stage distribution: the smaller the tumor was, the more likely the disease was stage I (p < 0.01). For tumor < 15 mm in diameter, the proportion of stage I was 76.67%, compared to 57.47% for 16–25 mm, 49.74% for 26–35 mm, 42.48% for 36–45 mm, 36.07% for > 46 mm. The mean tumor size of case with stage I was 36.16 ± 21.27 mm, compared to 45.43 ± 21.72 mm for case with stage II, 46.18 ± 22.68 mm for case with stage IIIA, 45.06 ± 25.13 mm for case with stage IIIB+IV. The tumor size of stage I was smaller than all the other case of stage II to stage IV (p < 0.01).
There is a statistically significant relation between the tumor size and the distribution of disease stage of primary NSCLC: the smaller the tumor was, the more likely the disease was stage I.
The results suggest that CT screening may detect NSCLC at earlier stage when the tumor size was smaller, resulting in stage shift, and ultimately, a reduction in lung cancer mortality.
Haiquan Chen, No Financial Disclosure Information; No Product/Research Disclosure Information