Survival in operable non-small-cell lung cancer: role of p53 mutations, tobacco smoking and asbestos exposure.
Validated markers are needed to identify operable lung cancer patients with poor prognosis. About one-half of non-small-cell lung cancers (NSCLCs) carry a mutation in the p53 tumor-suppressor gene. We examined 101 NSCLC patients for surgical stage, completeness of resection, tobacco smoking, asbestos exposure, age, gender and p53 gene mutations as prognostic factors after a follow-up period of 4 years. Cox's multivariate regression model was applied to quantify the associations with overall and cancer-related survival. Patients with a wild-type p53 gene had an overall 4-year survival of 43% and those with a mutated p53 gene, 35%. In squamous-cell carcinoma, stage and heavy smoking, defined as the median of pack-years smoked, had prognostic significance for overall survival. Only stage was associated with poor cancer-related survival. Asbestos exposure was not associated with overall survival or cancer-related survival in squamous-cell carcinoma or adenocarcinoma. In adenocarcinoma, p53 mutation, in addition to stage, emerged as a significant predictor of poor cancer-related survival.
Sioris
T
T
Department of Surgery, Tampere University Hospital, Tampere, Finland. sioris@saunalahti.fi
Husgafvel-Pursiainen
K
K
Karjalainen
A
A
Anttila
S
S
Kannio
A
A
Salo
J A
JA
Perhoniemi
V
V
Heikkilä
L
L
Vainio
H
H
D000328:Adult; D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality*; D005260:Female; D016158:Genes, p53; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D012907:Smoking / Q000009:adverse effects*; D015996:Survival Rate
D001194:Asbestos