Cause-specific Analysis of Risk Factors in Completely Resected Pathologic Stage Ia Non-small Cell Lung Cancer.
- Author:
Seong Yong PARK
1
;
In Kyu PARK
;
Chun Sung BYUN
;
Chang Young LEE
;
Mi Kyung BAE
;
Dae Joon KIM
;
Kyung Young CHUNG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Center for Lung Cancer, Research Institute and Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Lung neoplasm;
Postoperative care;
Neoplasm recurrence
- MeSH:
Carcinoma, Non-Small-Cell Lung;
Chemotherapy, Adjuvant;
Follow-Up Studies;
Humans;
Lung Neoplasms;
Medical Records;
Pneumonectomy;
Postoperative Care;
Proportional Hazards Models;
Recurrence;
Retrospective Studies;
Risk Factors;
Small Cell Lung Carcinoma;
Survival Rate;
Treatment Failure
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2009;42(6):725-731
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Lobectomy and more extended anatomic resection are regarded as standard treatment for stage Ia non-small cell lung cancer, but approximately 15~40% of patients suffer from treatment failures such as cancer recurrence or death. The authors analyzed types and causes of treatment failures in surgically treated cases of stage Ia non small cell lung cancer. MATERIAL AND METHOD: We retrospectively reviewed the medical records of 156 patients who had undergone complete resection for stage Ia NSCLC between Jan 1992 and Aug 2005. Patients were divided into two different treatment failure groups: cancer-related deaths and non-cancer-related deaths. Risk factors were analyzed in each group by the Kaplan-Meyer survival method and the Cox proportional hazard model. RESULT: Among the 156 patients, 93 were males; the mean age was 61. The median follow-up period was 33.8 months. The 5 year survival rate was 87.6%. Microscopic lympho-vascular permeation was reported in 10 patients. Recurrence was reported in 19 patients and 12 patients died due to recurrent lung cancer. Non- cancer related deaths occurred in 16 patients. Risk factors for cancer recurrence and cancer related death were microscopic lympho-vascular permeation (HR=6.81, p=0.007, HR=7.81, p<0.001); for non-cancer related death, risk factors were pneumonectomy (HR=25.92, p=0.001) and postoperative cardiopulmonary complications (HR=29.67, p=0.002). CONCLUSION: After complete resection of stage Ia non small cell lung cancer patients, mortality includes not only cancer related deaths but also cancer unrelated deaths. Adjuvant chemotherapy is advised for patients who show microscopic lympho-vascular permeation, which is a risk factor for recurrence and for cancer related death. Patients who had pneumonectomy or who suffered from cardiac or respiratory complications need meticulous care in order to reduce comorbidity-induced death.
