Original articleGeneral thoracicComparison Between Clinical and Pathologic Staging in 2,994 Cases of Lung Cancer
Section snippets
Patients
All the patients included in the study had lung cancer in initial stages and had undergone thoracotomy with intent to cure in hospitals pertaining to the Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery [11].
We included prospectively all patients treated surgically from October 1993 to September 1997 in hospitals participating in the GCCB-S. The annual cumulative number of cases was close to 50% of surgical cases occurring in Spain. The
Descriptive Study
The majority of patients were male (2,771; 93%), mean age was 64 years (SD, 9.6; median, 66; minimum, 30; maximum, 91; 25th percentile, 59; 50th percentile, 66; 75th percentile, 71). Eighty-seven percent of cases were smokers or ex-smokers; in 2,585 patients it was possible to determine the level of smoking, with a mean of 57.5 package-year (SD, 30; median, 50). Of the 2,994 patients, 57% admitted being an active smoker.
Table 1 shows the rest of the characteristics for these cases. The
Comment
The main objective of this study on a recent series of 2,994 lung cancer cases compiled by the GCCB-S is to analyze the accuracy of the clinical staging by comparing it against the best gold standard, pathologic staging. Of the three staging components, this comparison is only valid for T and for N, given that thoracotomy, the gold standard for this staging, can hardly modify the M clinical classification. This study shows that both staging methods coincide in fewer than half of cases, with a
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