title: Local failure after complete resection of N0-1 non-small cell lung cancer.
abstract: OBJECTIVE
  To estimate the risk of local-regional failure (LRF) after surgery for operable NSCLC, and the effect of clinical/pathologic factors on this risk.
  
  
  METHODS
  Records of 335 patients undergoing complete resection (lobectomy, pneumonectomy) for pathological T1-4 N0-1 NSCLC (without post-operative radiation) from 1996 to 2006 were reviewed. Crude and actuarial estimated failure rates were computed; local-regional sites included ipsilateral lung, surgical stump, hilar, mediastinal, or supraclavicular nodes. Failure times in sub-groups were calculated with the Kaplan-Meier method and compared via log-rank test. Independent factors adversely affecting LRF were determined with Cox regression.
  
  
  RESULTS
  The median follow-up duration for event-free surviving patients was 40 months (range: 1-150). The crude and actuarial 5-year probability of any failure (LR or distant) were 33% and 43%, respectively. Of all failures; 37% were LR only, 35% LR and distant and 28% distant only. The 5-year crude and actuarial probability of LRF were 24% and 35% (95% CI: 29-42%). Five-year crude LRF rates for T1-2N0, T1-2N1, T3-4N0 and T3-4N1 disease were 19% (41/216), 27% (16/59), 37.5% (15/40) and 40% (8/20), respectively. The corresponding actuarial estimates were T1-2N0 28%, T1-2N1 39%, T3-4N0 50% and T3-4N1 67%. In Cox multiple regression analysis, lymphovascular space invasion (p=0.03, HR: 1.7) and tumor size (p=0.01, HR: 1.67 for 5 cm increment) were associated with an increased risk of LRF.
  
  
  CONCLUSIONS
  Five-year LRF rates are ≥19% in essentially all patient subsets.
authors.affiliation: Department of Radiation Oncology, University of North Carolina at Chapel Hill, NC 27514, United States.
authors.forename: Mert
authors.initials: M
authors.lastname: Saynak
authors.forename: Nirmal K
authors.initials: NK
authors.lastname: Veeramachaneni
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Hubbs
authors.forename: Jiho
authors.initials: J
authors.lastname: Nam
authors.forename: Bahjat F
authors.initials: BF
authors.lastname: Qaqish
authors.forename: Janet E
authors.initials: JE
authors.lastname: Bailey
authors.forename: Wonil
authors.initials: W
authors.lastname: Chung
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Marks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome