Lung Cancer

Lung cancer is the leading cause of cancer deaths in the world. The prognosis of non–small cell lung carcinoma (NSCLC) largely depends on tumor stage; indeed, the overall low survival rate (about 15% at 5 years) is primarily due to the high frequency of late diagnosis, when the tumor has become unresectable. Early-stage NSCLC patients (stage I–II) have a significantly better prognosis (30%–60% survival at 5 years). One important issue in stage I NSCLC is that current diagnostic tools do not allow precise prognostic evaluation. In turn, this limits the power of clinical trials aimed at ameliorating prognosis through multimodality therapy. A case in point is represented by adjuvant chemotherapy, on which conflicting results in stage IB have been reported. Consequently, there is presently no indication for adjuvant treatment in stage I NSCLC. Evidently enough, the availability of accurate prognostic markers might change this picture by allowing the selection, for clinical trials, of only those patients with a high risk of relapse. Thus, there is need for reliable prognostic indicators, both for diagnostic and prognostic purposes and for the design of clinical trials.