title: Risk factors for both recurrence and survival in patients with pathological stage I non-small-cell lung cancer.
abstract: OBJECTIVE
  Even after curative resection, a significant fraction of patients with stage I non-small-cell lung cancer (NSCLC) die primarily because of systemic relapse. The purpose of the present study was to investigate the risk factors for both recurrence and poor survival in patients with pathological (p-) stage I NSCLC.
  
  
  METHODS
  We retrospectively reviewed 467 consecutive patients from a single institution with completely resected p-stage I NSCLC. Patients with multiple lung tumours or malignancies from other organs and those who had undergone preoperative therapies were excluded. The correlation between clinicopathological factors and surgical outcomes, including disease-free survival (DFS) and overall survival (OS), was analysed. The clinicopathological factors examined were age, gender, smoking history, serum carcinoembryonic antigen (CEA) levels, serum cytokeratin 19 fragment levels, surgical procedure, tumour histology, p-stage, angiolymphatic invasion and differentiation grade.
  
  
  RESULTS
  The 5-year DFS and OS rates of the total study population were 91.4 and 92.8%, respectively. Multivariate analysis results indicated that high serum CEA levels (>5.0 ng/ml) and p-stage IB were independent factors for recurrence, whereas older age (>70 years), high serum CEA levels and p-stage IB were independent factors for poor survival. The risks of recurrence and death in patients with both high serum CEA levels and p-stage IB was 10.3 and 5.2 times higher than those observed in patients with both normal serum CEA levels and p-stage IA, respectively.
  
  
  CONCLUSIONS
  High serum CEA levels and p-stage IB were independent factors for both recurrence and poor survival in p-stage I NSCLC patients.
authors.affiliation: Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan. y.kozu@scchr.jp
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kozu
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Maniwa
authors.forename: Shoji
authors.initials: S
authors.lastname: Takahashi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Isaka
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Ohde
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002272:Carcinoembryonic Antigen / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D002272:Carcinoembryonic Antigen
keywords: Carcinoembryonic antigen; Non-small-cell lung cancer; Pathological stage; Recurrence and poor survival; Risk factor