[Prognosis of non-small cell lung cancer patients with microscopic residual disease at bronchial stump after lung resection].
OBJECTIVE
To investigate the prognosis of patients of non-small cell lung cancer (NSCLC) receiving lobectomy or pneumonectomy with microscopic residual disease (MRD) at the bronchial resection margin postoperatively and analyze the factors influencing prognosis.


METHODS
The data of 1 218 patients who under went lobectomy or pneumonectomy for NSCLC 1965 approximately 1995 were retrospectively studied. Staging was done according to the TNM and UICC classifications. The factors influencing survival were analysed with Likelihood Ratio method.


RESULTS
Of the 1 218 patients, 62 suffered form MRD (5.1%) at the bronchial margin postoperatively, including 21 MMRD cases and 41 EMRD cases, with a median survival time of 44 months and a five-year survival rate of 33.9%. Forty-two patients received adjuvant chemotherapy after operation. According to pTNM classification,the five-year survival rate was 51.4% for stage I,16.7% for stage II,and 6.7% for stage III a respectively, being significantly higher for stage I than for stage II and III a (P = 0.001 1). The 5-year survival rate in the MMRD group was 57.1%, significantly higher than that in the EMRD group (22.0%, P = 0.0078). The five-year survival rate in the MRD patients who received adjuvant therapy postoperatively was 42.86%, significantly higher than that in those without postoperative therapy (15%, P = 0.002).


CONCLUSIONS
The factors influencing the prognosis of MRD patients receiving lobectomy or pneumonectomy for NSCLC include the pathological stage and the type of infiltration of MRD. Chemotherapy after operation improves the prognosis in those patients.
Department of Thoracic Surgery, General Hospital of the People's Liberation Army, Beijing 100853  China.
Weimin
W
Dai
Changhai
C
Yu
Yu'e
Y
Sun
D000328:Adult; D000368:Aged; D001980:Bronchi / Q000473:pathology*; 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; D018365:Neoplasm, Residual; D011013:Pneumonectomy; D011379:Prognosis; D015996:Survival Rate