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Prognostic Impact of Newly Proposed M Descriptors in TNM Classification of Non-Small Cell Lung Cancer

Cited 13 time in Web of Science Cited 14 time in Scopus
Authors
Shin, Junghoon; Keam, Bhumsuk; Kim, Miso; Park, Young Sik; Kim, Tae Min; Kim, Dong-Wan; Kim, Young Whan; Heo, Dae Seog
Issue Date
2017-03
Citation
Journal of Thoracic Oncology, Vol.12 No.3, pp.520-528
Keywords
NSCLCTNM stagingExternal validationPrognosis
Abstract
Introduction: The International Association for the Study of Lung Cancer recently proposed new M descriptors for the next edition of the TNM classification for NSCLC, subdividing the current M1b category into two subcategories: M1b, which indicates a solitary extrathoracic metastasis in a single organ, and M1c, which indicates multiple extrathoracic metastasis. The purpose of this study was to validate the prognostic value of the newly proposed M descriptors in an independent cohort with multivariate and subgroup analysis. Methods: A total of 1024 patients in a consecutive lung cancer database who had stage IV NSCLC treated between 2011 and 2014 were analyzed. Newly proposed M staging was used for classification and comparison of survival. Adjustment for other clinical covariates and subgroup analysis was conducted. Results: According to the newly proposed M descriptors, 262 patients (25.6%), 152 patients (14.8%), and 610 patients (59.6%) were classified into the subgroups M1a, M1b, and M1c, respectively. The median overall survival times were 22.5, 17.8, and 13.6 months for the M1a, M1b, and M1c groups, respectively (p < 0.001). After adjustment for other covariates, Cox proportional hazards regression revealed statistically significantly shorter overall survival for the M1b group than for the M1a group (hazard ratio = 1.30; 95% confidence interval: 1.03-1.65, p = 0.03) and for the M1c than the M1b group (hazard ratio = 1.57; 95% confidence interval: 1.28-1.93, p < 0.001). These differences showed a consistent tendency regardless of pathologic and molecular subtypes. Conclusions: The newly proposed M descriptors have prognostic value in patients with stage IV NSCLC. (C) 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.
ISSN
1556-0864
URI
https://hdl.handle.net/10371/165265
DOI
https://doi.org/10.1016/j.jtho.2016.11.2216
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College of Medicine/School of Medicine (의과대학/대학원)Cancer Research Institute (암연구소)Journal Papers (저널논문_암연구소)
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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