title: Prognostic factors in non-small cell lung cancer surgery.
abstract: OBJECTIVE
  Complete surgical resection of primary tumours remains the treatment with the greatest likelihood for survival in early-stage non-small cell lung cancer (NSCLC). Although TNM stage is the most important prognostic parameter in NSCLC, additional parameters are required to explain the large variability in postoperative outcome. The present review aims at providing an overview of the currently known prognostic markers for postoperative outcome.
  
  
  METHODS
  We performed an electronic literature search on the MEDLINE database to identify relevant studies describing the risk factors in NSCLC surgery. The references reported in all the identified studies were used for completion of the literature search.
  
  
  RESULTS
  Poor pulmonary function, cardiovascular disease, male gender, advanced age, TNM stage, non-squamous cell histology, pneumonectomy, low hospital volume and little experience of the surgeon were identified as risk factors for postoperative outcome. However, with the exception of TNM stage and extent of resection, the literature demonstrates conflicting results on the prognostic power of most factors. The role of molecular biological factors, neoadjuvant treatment and adjuvant treatment is not well investigated yet.
  
  
  CONCLUSIONS
  The advantage of knowing about the existence of comorbidity and prognostic risk factors may provide the clinician with the ability to identify poor prognostic patients and establish the most appropriate treatment strategy. The assessment of prognostic factors remains an area of active investigation and a promising field of research in optimising therapy of NSCLC patients.
authors.affiliation: Department of Cardio-Thoracic Surgery, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: O
authors.initials: O
authors.lastname: Birim
authors.forename: A P
authors.initials: AP
authors.lastname: Kappetein
authors.forename: R J
authors.initials: RJ
authors.lastname: van Klaveren
authors.forename: A J J C
authors.initials: AJ
authors.lastname: Bogers
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D015996:Survival Rate