title: Metastatic index of non-small-cell lung cancer and long-term survival.
abstract: OBJECTIVE
  We aimed to determine whether metastatic index is a factor determining long-term survival in patients undergoing curative resection for non-small-cell lung cancer.
  
  
  METHODS
  There were 2695 consecutive pulmonary resections performed between October 2001 and September 2011 in our institution; 1795 were potentially curative resections for non-small-cell lung cancer with bronchial margin length data available. Benchmarking against the International Association for the Study of Lung Cancer data set was performed. Cox multivariate analysis was undertaken. Metastatic index was defined as N stage× bronchial resection margin length.
  
  
  RESULTS
  Benchmarking failed to reveal any significant differences between our data and the International Association for the Study of Lung Cancer data set. Univariate analysis identified metastatic index as a significant factor determining long-term survival (p = 0.04). Cox regression demonstrated that metastatic index (hazard ratio 1.29, p = 0.0002), age (hazard ratio 1.02, p < 0.0001), body mass index (hazard ratio 0.98, p = 0.006), female sex (hazard ratio 0.65, p < 0.0001), T1 stage (hazard ratio 0.67, p < 0.0001), T2 stage (hazard ratio 2.13, p < 0.0001), T3 stage (hazard ratio 1.59, p = 0.03), forced expiratory volume in 1 s (hazard ratio 0.70, p < 0.0001), pneumonectomy (hazard ratio 1.43, p = 0.001), histology subtype adenosquamous (hazard ratio 3.77, p = 0.01) and squamous (hazard ratio 0.83, p = 0.03) were all significant determinants of long-term survival.
  
  
  CONCLUSIONS
  Metastatic index is a significant factor determining long-term survival in patents with adenocarcinoma undergoing potentially curative surgery with a lobectomy.
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK mpoullis@hotmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Poullis
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Shackcloth
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Page
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Julius
authors.initials: J
authors.lastname: Asanti-Siaw
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Woolley
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Mediratta
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D019985:Benchmarking; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D016208:Databases, Factual; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Bronchi; carcinoma; lung neoplasms; neoplasm staging; non-small-cell lung; prognosis