Completely Resected N0 Non-Small Cell Lung Cancer: Prognostic Factors Affecting Long-Term Survival

Author:

Tantraworasin Apichat1,Saeteng Somcharoen1,Lertprasertsuke Nirush2,Arayawudhikule Nuttapon3,Kasemsarn Choosak4,Patumanond Jayanton5ORCID

Affiliation:

1. General Thoracic Unit, Department of Surgery, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai 50200, Thailand

2. Department of Pathology, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai 50200, Thailand

3. Cardiovascular Thoracic Unit, Department of Surgery, Lampang Hospital, Lampang 52000, Thailand

4. Cardiovascular Thoracic Unit, Department of Surgery, Chest Institute, Nonthaburi 11000, Thailand

5. Department of Community Medicine, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai 50200, Thailand

Abstract

Background. Although early stage non-small cell lung cancer (NSCLC) has an excellent outcome and correlated with good long-term survival, up to 15 percent of patients still relapse postoperatively and die. This study is conducted to identify prognostic factors that may affect the long-term survival in completely resected N0 NSCLC. Methods. Medical records of 124 patients with completely resected N0 NSCLC were retrospectively reviewed. Prognostic factors affecting long-term survival were analyzed by the Kaplan-Meier method and Cox proportional hazards analysis. Results. Overall five-year survival rate was 48 percent. Multivariable analysis revealed stage of disease, tumor necrosis, tumor recurrence, brain metastasis, adrenal metastases, and skin metastases as significant prognostic factors affecting long-term survival. The hazard ratio (HR) of tumor necrosis, tumor recurrence, brain metastasis, adrenal metastases, and skin metastases was 2.0, 2.3, 7.6, 4.1, and 8.3, respectively, and all P values were less than 0.001. Conclusions. Our study shows stage of disease, tumor necrosis, tumor recurrence, brain metastasis, adrenal metastasis, and skin metastasis as the independent prognostic factors of long-term survival in pathological N0 NSCLC. Early stage NSCLC patients without nodal involvement or presented with tumor necrosis should benefit from adjuvant chemotherapy, and sites of metastasis could predict the long-term survival as described.

Funder

Chiang Mai University

Publisher

Hindawi Limited

Subject

General Chemical Engineering

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