Mortality in early-stage, surgically resected non-small cell lung cancer less than 3 cm of size: Competing risk analysis

Autores de IIS La Fe

• Nuria Mancheño Franch

  Autor

Participantes ajenos a IIS La Fe

• Aragon, CJ
• Cuesta, JCP
• Quevedo, KD
• Sempere, FV
• Alarcon, JP

Abstract

Background and objective: Survival studies of non-small cell lung cancer (NSCLC) are usually based on the Kaplan-Meier method. However, other factors not covered by this method may modify the observation of the event of interest. There are models of cumulative incidence (CI), that take into account these competing risks, enabling more accurate survival estimates and evaluation of the risk of death from other causes. We aimed to evaluate these models in resected early-stage NSCLC patients. Patients and method: This study included 263 patients with resected NSCLC whose diameter was <= 3 cm without node involvement (NO). Demographic, clinical, morphopathological and surgical variables, TNM classification and long-term evolution were analysed. To analyse Cl, death by another cause was considered to be competitive event. For the univariate analysis, Gray's method was used, while Fine and Gray's method was employed for the multivariate analysis. Results: Mortality by NSCLC was 19.4% at 5 years and 14.3% by another cause. Both curves crossed at 6.3 years, and probability of death by another cause became greater from this point. In multivariate analysis, cancer mortality was conditioned by visceral pleural invasion (VPI) (P = .001) and vascular invasion (P = .020), with age > 50 years (P = .034), smoking (P = .009) and the Charlson index >= 2 (P = .000) being by no cancer. Conclusions: By the method of CI, VPI and vascular invasion conditioned cancer death in NSCLC > 3 cm, while non-tumor causes of long-term death were determined. (C) 2014 Elsevier Espana, S.L.U. All rights reserved.

Keywords

• Non-small cell lung cancer; Surgery; Survival; Competing risks analysis