title: [Clinical and paraclinical prognostic factors in non-small cell lung cancer surgery].
abstract: BACKGROUND
  Lung cancer prognosis is mainly based on the TNM, histology and molecular biology. Our aim was to analyze the prognostic value of certain clinical and paraclinical variables.
  
  
  METHODS
  We studied among 6105 patients operated on, divided during 3 time-periods (1979 to 2010), the following prognostic factors: type of surgery, pTNM, histology, age, sex, smoking history, clinical presentation, and paraclinical variables.
  
  
  RESULTS
  Postoperative mortality was 4% (243/6105), rate of complications was 23.3% (1424/6105). The 5-year overall survival was 43.2% and 10-year was 27%. Best survival was observed after complete resection (R0) (P<10(-6)), lobectomy (P<10(-6)), lymph node dissection (P=0.0006), early pTNM stages (P<10(-6)), absence of a solid component in adenocarcinoma. Other pejorative factors were: male gender (P=10(-5)), age (P=0.0000002), comorbidity (P=0.016), history of cancer (P<10(-5)), postoperative complications (P=0.0018), FEV lower than 80% (P=0.0000025), time-periods (P<10(-6)). All these factors were confirmed by multivariate analysis, except gender. Smoking was not poor prognostic factor in univariate analysis (P=0.09) but became significant in the multivariate one (P=0.013).
  
  
  CONCLUSIONS
  Medical and human factors, and the general physiological state, play an important role in prognosis after surgery. We do not know their exact meaning and, like studies on chemotherapy, they justify special research.
authors: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20, rue Leblanc, 75015 Paris, France. Electronic address: marc.riquet@egp.aphp.fr.
authors: M
authors: M
authors: Riquet
authors: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20, rue Leblanc, 75015 Paris, France.
authors: C
authors: C
authors: Rivera
authors: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20, rue Leblanc, 75015 Paris, France.
authors: C
authors: C
authors: Pricopi
authors: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20, rue Leblanc, 75015 Paris, France.
authors: A
authors: A
authors: Badia
authors: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20, rue Leblanc, 75015 Paris, France.
authors: A
authors: A
authors: Arame
authors: Service de chirurgie thoracique, centre médico-chirurgical du Cèdre, 76230 Bois-Guillaume, France.
authors: A
authors: A
authors: Dujon
authors: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20, rue Leblanc, 75015 Paris, France.
authors: C
authors: C
authors: Foucault
authors: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20, rue Leblanc, 75015 Paris, France.
authors: F
authors: F
authors: Le Pimpec-Barthes
authors: Service d'oncologie médicale, hôpital européen Georges-Pompidou, université Paris Descartes, 75015 Paris, France.
authors: E
authors: E
authors: Fabre
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D005602:France / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011013:Pneumonectomy; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects
keywords: Cancer du poumon non à petites cellules; Chirurgie pulmonaire; Clinical and paraclinical prognostic factors; Facteurs pronostiques clinique et paraclinique; Lung surgery; Non-small cell lung cancer