title: A clinical model to estimate recurrence risk in resected stage I non-small cell lung cancer.
abstract: OBJECTIVE
  There are no reliable markers to predict recurrence in resected Stage I non-small cell lung cancer (NSCLC). A validated clinical model to estimate the risk of recurrence would help select patients for adjuvant therapy.
  
  
  METHODS
  We reviewed the medical records of 715 patients who had a potentially curative resection for Stage I NSCLC at our institution from 1990 to 2000. Recurrence rates were estimated by the Kaplan-Meier method. A model to estimate risk of recurrence was developed by combining independent risk factors.
  
  
  RESULTS
  With a median follow-up of 4.7 years, the 5-year survival rates for Stages IA and IB were 66% and 55% respectively, and 5-year recurrence rates were 19% and 30%, respectively. Four factors were independently associated with tumor recurrence: tumor size >3 cm (hazard ratio [HR] = 2.4), surgery other than lobectomy (HR = 2.0), nonsquamous histology (HR = 1.4), and high-grade cellular differentiation (HR = 1.4). A scoring system for recurrence was developed by assigning 2 points for each major risk factor (tumor size and surgery) and 1 point for each minor risk factor (histologic subtype and cellular grade). Scores were grouped as low (0-1), intermediate (2-3), and high (>3), yielding 5-year estimates of risk of recurrence of 14%, 27%, and 43%, respectively.
  
  
  CONCLUSIONS
  This model, based upon readily available clinicopathologic characteristics, can estimate the risk of recurrence in Stage I NSCLC, independent of T classification. This model could be used to select patients for adjuvant therapy if validated in independent data sets.
authors: Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors: Boone
authors: B
authors: Goodgame
authors: Avinash
authors: A
authors: Viswanathan
authors: C Ryan
authors: CR
authors: Miller
authors: Feng
authors: F
authors: Gao
authors: Bryan
authors: B
authors: Meyers
authors: Richard J
authors: RJ
authors: Battafarano
authors: Alexander
authors: A
authors: Patterson
authors: Joel
authors: J
authors: Cooper
authors: Tracey J
authors: TJ
authors: Guthrie
authors: Jeffrey
authors: J
authors: Bradley
authors: Giancarlo
authors: G
authors: Pillot
authors: Ramaswamy
authors: R
authors: Govindan
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery; D000368:Aged; D018287:Carcinoma, Large Cell / Q000175:diagnosis / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D008954:Models, Biological; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate