title: Factors associated with recurrence in patients with curatively resected stage I-II lung cancer.
abstract: BACKGROUND
  Patients with stage I-II non-small cell lung cancer (NSCLC) show variability in recurrence after curative resection. Several factors have been proposed as prognostic of recurrence in previous studies. However, because of the heterogeneity of the populations studied, these reports did not yield consistent results. The aim of our study was to identify risk factors for recurrence in patients with curatively resected stage I-II NSCLC.
  
  
  METHODS
  We reviewed the medical records of pathological stage I-II NSCLC patients after curative surgery performed in a tertiary referral center (Seoul National University Hospital) from January 2002 to December 2004. Demographic factors, radiological, histopathological, and laboratory findings, and surgery-related factors were analyzed. Patients with invasive cancer other than lung cancer that was present 5 years prior to surgery were excluded. The Cox proportional hazard regression model was used for multivariate analyses.
  
  
  RESULTS
  Three hundred and ten patients were included. Among them, local recurrence occurred in 27 patients (8.7%), whereas distant recurrence occurred in 79 patients (25.5%). Adenocarcinoma histology (OR, 2.74; 95% CI, 1.14-6.58; P=0.024), carcinoembryonic antigen (CEA) level>2.3 ng/mL (OR, 2.26; 95% CI, 1.02-5.00; P=0.045), and standard uptake values (SUV) of tumor in positron emission tomography (PET)>4.5 (OR, 5.45; 95% CI, 1.82-16.31; P=0.002) were independent predictors of recurrence in addition to TNM stage. We also constructed a recurrence prediction model based on these findings, which yielded better diagnostic performance than the TNM staging system.
  
  
  CONCLUSIONS
  Adenocarcinoma histology, CEA level, and SUV of PET could be considered as prognostic factors for recurrence in patients with curatively resected stage I-II NSCLC.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea.
authors.forename: Hyeon-Kyoung
authors.initials: HK
authors.lastname: Koo
authors.forename: Sang-Man
authors.initials: SM
authors.lastname: Jin
authors.forename: Chang-Hoon
authors.initials: CH
authors.lastname: Lee
authors.forename: Hyo-Jeong
authors.initials: HJ
authors.lastname: Lim
authors.forename: Jae-Joon
authors.initials: JJ
authors.lastname: Yim
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Seok-Chul
authors.initials: SC
authors.lastname: Yang
authors.forename: Chul-Gyu
authors.initials: CG
authors.lastname: Yoo
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Han
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Shim
authors.forename: Young Whan
authors.initials: YW
authors.lastname: Kim
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure