Análisis multicéntrico de supervivencia y factores pronósticos en el carcinoma no microcítico de pulmón en estadio I patológico según la nueva clasificación TNM de 2009

Resumen Introduccion La nueva clasificacion TNM de 2009 ha introducido importantes modificaciones en la estadificacion del cancer de pulmon. El objetivo de este trabajo es validar nuestra serie de pacientes con carcinoma no microcitico de pulmon en estadio I patologico segun la septima edicion de la clasificacion TNM de los tumores malignos y analizar los factores relacionados con el pronostico. Pacientes y metodos Se realizo un estudio retrospectivo y multicentrico. Para el analisis de supervivencia se utilizo el metodo de Kaplan-Meier y para el analisis multivariable, la regresion de Cox. Se analizaron las siguientes variables: edad, sexo, estadio patologico, categoria T, tipo histologico, tipo de reseccion y tamano tumoral. Resultados Se incluyo a 402 pacientes con un seguimiento medio de 70,18 meses. La supervivencia global a los 5 anos fue del 68%. Los varones y los pacientes mayores de 70 anos tenian una menor supervivencia. El pronostico empeoraba a medida que aumentaba el estadio patologico, la categoria T y el tamano tumoral. No encontramos diferencias pronosticas estadisticamente significativas en relacion con el tipo histologico y el tipo de reseccion practicada. El analisis multivariable mostro que la edad, el sexo y el estadio patologico son factores pronosticos independientes. Conclusiones Los resultados de supervivencia y el analisis de factores pronosticos de nuestra serie se ajustan a los publicados en la nueva clasificacion TNM de 2009. El factor pronostico mas importante es el estadio patologico. Otros factores pronosticos desfavorables son el sexo masculino y la edad mayor de 70 anos.

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