Stage I non-small cell lung cancer: a pragmatic approach to prognosis after complete resection.
BACKGROUND
Long-term results of the surgical treatment of stage I non-small cell lung cancer (NSCLC) are disappointing.


METHODS
Univariate and multivariate analyses were conducted on 515 consecutive lung resections for stage I NSCLC performed from 1990 to 1999 and identified by reviewing a database into which data were entered prospectively. Tumors were staged as stages IA (n = 147) and IB (n = 348) according to the 1997 UICC (Union Internationale Contre le Cancer) pTNM classification.


RESULTS
Operative mortality rates were 6.2%, 5.3%, 2.3%, and 0% for pneumonectomy, bilobectomy, lobectomy, and lesser resections, respectively. Overall survival rate was 61.1% (55.8% to 66.5%) at 5 years. Univariate analysis identified three significant adverse prognosticators: arteriosclerosis as comorbidity, pathologic T2 status, and blood vessel invasion. Male sex (p = 0.056) and performance of pneumonectomy (p = 0.057) were at the threshold of statistical significance. At multivariate analysis, three independent prognosticators entered the model: arteriosclerosis, blood vessels invasion, and performance of pneumonectomy.


CONCLUSIONS
Long-term survival of patients with completely resected stage I NSCLC was adversely influenced in a relatively balanced way by factors related to the clinical status of the patient, to the tumor, and to the treatment.
Thomas
Pascal
P
Department of Thoracic Surgery and Lung Transplantation, Ste Marguerite Hospital, University Méditerranée (Aix-Marseille II), School of Medicine, France. pathomas@ap-hm.fr
Doddoli
Christophe
C
Thirion
Xavier
X
Ghez
Olivier
O
Payan-Defais
Marie-José
MJ
Giudicelli
Roger
R
Fuentes
Pierre
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000401:mortality; D011379:Prognosis; D015996:Survival Rate