title: Prognostic factors for lymph node negative stage I and IIA non-small cell lung cancer: multicenter experiences.
abstract: BACKGROUND
  Surgery is the only curative treatment for operable non-small lung cancer (NSCLC) and the importance of adjuvant chemotherapy for stage IB patients is unclear. Herein, we evaluated prognostic factors for survival and factors related with adjuvant treatment decisions for stage I and IIA NSCLC patients without lymph node metastasis.
  
  
  METHODS
  We retrospectively analyzed 302 patients who had undergone curative surgery for prognostic factors regarding survival and clinicopathological factors related to adjuvant chemotherapy.
  
  
  RESULTS
  Nearly 90% of the patients underwent lobectomy or pneumonectomy with mediastinal lymph node resection. For the others, wedge resection were performed. The patients were diagnosed as stage IA in 35%, IB in 49% and IIA in 17%. Histopathological type (p=0.02), tumor diameter (p=0.01) and stage (p<0.001) were found to be related to adjuvant chemotherapy decisions, while operation type, lypmhovascular invasion (LVI), grade and the presence of recurrence were important factors in predicting overall survival (OS), and operation type, tumor size greater than 4 cm, T stage, LVI, and visceral pleural invasion were related with disease free survival (DFS). Multivariate analysis showed operation type (p<0.001, hazard ratio (HR):1.91) and the presence of recurrence (p<0.001, HR:0.007) were independent prognostic factors for OS, as well visceral pleural invasion (p=0.01, HR:0.57) and LVI (p=0.004, HR:0.57) for DFS.
  
  
  CONCLUSIONS
  Although adjuvant chemotherapy is standard for early stage lymph node positive NSCLC, it has less clear importance in stage I and IIA patients without lymph node metastasis.
authors.affiliation: Department of Medical Oncology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey E-mail : basakoven@yahoo.com.
authors.forename: Bala Basak
authors.initials: BB
authors.lastname: Oven Ustaalioglu
authors.forename: Olcun Umit
authors.initials: OU
authors.lastname: Unal
authors.forename: Nedim
authors.initials: N
authors.lastname: Turan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bilici
authors.forename: Serap
authors.initials: S
authors.lastname: Kaya
authors.forename: Tulay
authors.initials: T
authors.lastname: Eren
authors.forename: Arife
authors.initials: A
authors.lastname: Ulas
authors.forename: Ali
authors.initials: A
authors.lastname: Inal
authors.forename: Veli
authors.initials: V
authors.lastname: Berk
authors.forename: Umut
authors.initials: U
authors.lastname: Demirci
authors.forename: Suleyman
authors.initials: S
authors.lastname: Alici
authors.forename: Oznur
authors.initials: O
authors.lastname: Bal
authors.forename: Mustafa
authors.initials: M
authors.lastname: Benekli
authors.forename: Mahmut
authors.initials: M
authors.lastname: Gumus
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods; D011013:Pneumonectomy / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies