ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Ann Thorac Surg 2007;84:1825-1829. doi:10.1016/j.athoracsur.2007.07.016
© 2007 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Min-Hsiung Huang
Right arrow Permission Requests
Google Scholar
Right arrow Articles by Hsu, P.-K.
Right arrow Articles by Hsu, W.-H.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hsu, P.-K.
Right arrow Articles by Hsu, W.-H.
Related Collections
Right arrow Lung - cancer

Original Articles: General Thoracic

Effect of Formalin Fixation on Tumor Size Determination in Stage I Non-Small Cell Lung Cancer

Po-Kuei Hsu, MD*, Hsu-Chih Huang, MD*, Chih-Cheng Hsieh, MD*, Han-Shui Hsu, MD, Yu-Chung Wu, MD, Min-Hsiung Huang, MD, Wen-Hu Hsu, MD

Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital National Yang-Ming University, School of Medicine, Taipei, Taiwan

Accepted for publication July 6, 2007.

* Address correspondence to Dr Hsieh, Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan (Email: cchsieh2{at}vghtpe.gov.tw).

Background: Tumor size is an important prognostic factor in non-small cell lung cancer (NSCLC), but the American Joint Committee on Cancer staging system does not mandate a specific measurement method. Moreover, measuring fresh specimens and formalin-fixed specimens may yield disparate results. Our goal was to evaluate this disparity for stage I NSCLC.

Methods: We enrolled 401 patients with stage I NSCLC who underwent surgical interventions and follow-up in our hospital between 1993 and 2002. Tumors invading visceral pleura, involving the main bronchus, or associated with atelectasis or obstructive pneumonitis were excluded. Tumor size was measured immediately after resection by surgeons and after formalin fixation by pathologists. Patients were assigned to one of three groups. Group 1 included 201 patients with tumors of 3 cm or less as indicated by both operation notes and pathology reports. Group 2 included 160 patients with tumors larger than 3 cm by both records. Group 3 included 40 patients with tumors larger than 3 cm according to operation notes but 3 cm or less according to pathology reports. Survival rates were compared.

Results: Mean follow-up was 58 months. Five-year survival was 70.1% in group 1, 49.1% in group 2, and 51.1% in group 3. As expected, there was a significant survival difference between groups 1 and 2 (p < 0.001); however, there was also a difference between groups 1 and 3 (p = 0.006).

Conclusions: Formalin fixation may cause tumor shrinkage and migration from T2 to T1. For accurate tumor staging, size measurements should be performed immediately after resection instead of after formalin fixation. TNM staging should specify how to measure tumor size and the specimen status to be measured.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2007 by The Society of Thoracic Surgeons.