A survival analysis using physique-adjusted tumor size of non-small cell lung cancer.

BACKGROUND: Differences in individual body sizes have not been well considered when analyzing the survival of patients with non-small cell lung cancer (NSCLC). We hypothesized that physique-adjusted tumor size is superior to actual tumor size in predicting the prognosis.

METHODS: Eight hundred and forty-two patients who underwent R0 resection of NSCLC between 2005 and 2012 were retrospectively reviewed, and overall survival (OS) was evaluated. The physique-adjusted tumor size was defined as: x-adjusted tumor size = tumor size × mean value of x/individual value of x [x = height, weight, body surface area (BSA), or body mass index (BMI)]. Tumor size category was defined as ≤2, 2-3, 3-5, 5-7, and >7 cm. The separation index (SEP), which is the weighted mean of the absolute value of estimated regression coefficients over the subgroups with respect to a reference group, was used to measure the separation of subgroups.

RESULTS: The mean values of height, weight, BSA, and BMI were 160.7 cm, 57.6 kg, 1.59 m2 , and 22.2 kg/m2 , respectively. The 5-year survival rates ranged from 88-59% in the non-adjusted tumor size model (SEP 1.937), from 90-57% in the height-adjusted model (SEP 2.236), from 91-52% in the weight-adjusted model (SEP 2.146), from 90-56% in the BSA-adjusted model (SEP 2.077), and from 91-51% in the BMI-adjusted model (SEP 2.169).

CONCLUSIONS: The physique-adjusted tumor size can separate the survival better than the actual tumor size.