title: Clinical and molecular predictors of recurrence in stage I non-small cell lung cancer.
abstract: BACKGROUND
  Patients with stage I lung cancer undergoing a complete resection have a 25% risk of recurrence. Factors predictive for recurrence are critically needed. In the present study, we prospectively examined clinical and molecular factors that may predict a poor outcome.
  
  
  METHODS
  Patients with stage I non-small cell lung cancer undergoing surgical resection were enrolled into an institutional registry. Clinical demographics and outcomes data were prospectively collected. Patients who received neoadjuvant therapy or patients who died within 30 days of surgery were excluded from this analysis. Molecular factors involved in cell proliferation, cell cycle control, apoptosis, and angiogenesis were analyzed. The primary endpoint was recurrence-free survival.
  
  
  RESULTS
  One hundred and two patients were enrolled between March 2006 and April 2009. There were 25 (25%) documented recurrences. In univariate analysis, male sex, increased tumor standard uptake value, tumor size, final pathology stage, arterial invasion, percent nuclear phosphorylated AKT, vascular endothelial growth factor score, negative cyclin D1 protein expression, and percent nuclear cyclin D1 expression were predictive of decreased recurrence-free survival. All factors with a p value of 0.1 or less were included in multivariate analysis. Male sex, final pathology stage, vascular endothelial growth factor score, and percent nuclear cyclin D1 expression were significant independent predictors for poor prognosis.
  
  
  CONCLUSIONS
  Four clinical and molecular factors were associated with prognosis in a prospective study of stage I non-small cell lung cancer.
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Cincinnati Children's Hospital and Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, USA. sandra.starnes@uc.edu
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Starnes
authors.forename: Peterson
authors.initials: P
authors.lastname: Pathrose
authors.forename: Jiang
authors.initials: J
authors.lastname: Wang
authors.forename: Paul
authors.initials: P
authors.lastname: Succop
authors.forename: John C
authors.initials: JC
authors.lastname: Morris
authors.forename: James
authors.initials: J
authors.lastname: Bridges
authors.forename: Elena Y
authors.initials: EY
authors.lastname: Kupert
authors.forename: Marshall
authors.initials: M
authors.lastname: Anderson
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000235:genetics*; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology*; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor