The prospects for survival in non-small cell lung cancer are related to stage. Stage is a more important prognostic determinant than cell type, age or even treatment modality, and is second only to performance status in overall importance.
Stage is especially important in determining the prospects of cure with surgery.
In one prospective study we showed that despite the routine use of CT scanning and the liberal use of mediastinoscopy and mediastinotomy, cTNM was accurate in less than half of the patients coming to thoracotomy. The wider application of detailed intrathoracic staging and systematic nodal dissection will inevitably show this discrepancy to be even larger. They are of even less value for the individual patient.