title: Survival Prediction Model Using Clinico-Pathologic Characteristics for Nonsmall Cell Lung Cancer Patients After Curative Resection.
abstract: The current TNM staging system did not provide disease relapse information. The aim of study was try to establish a predictive survival model for disease and overall survival in nonsmall cell lung cancer patients who presented as resectable disease and to develop a reference for follow-up imaging tool selection.From January 2005 to December 2011, 442 patients who initially presented as resectable disease (stages I-IIIa) and received anatomic resection and mediastinal lymph node dissection were included in the study.Medical charts were thoroughly reviewed and clinico-pathologic factors were collected and analyzed.Visceral pleural invasion, tumor size >5 cm, and postoperative adjuvant therapy were identified as risk factors for poorer disease-free survival. The 5-year disease-free survival from score 0 to 3 was 68.7%, 46.6%, 31.9%, and 26.1%, respectively. The disease relapse percentage for scores 0 to 3 were 26.49%, 50.61%, 65.05%, and 73.81%, respectively. For analysis of overall survival, age >60 years, tumor size >3 cm, and total metastatic lymph node ratio >0.05 were correlated to worse overall survival. Because greater age may be correlated with poor general condition, we re-scored risk factors that correlated to disease severity that ranging from 0 to 2. The 5-year overall survival range from score 0 to 2 was 56.3%, 43.1%, and 13.1%, respectively.Poor prognostic factors correlated to disease-free survival were tumor size >5 cm, visceral pleural invasion, and patients needing to receive postoperative adjuvant therapy. Disease-free survival of resectable nonsmall cell lung cancer patients and disease relapse can be stratified by these 3 factors. Chest tomography may be recommended for patients with 1 or more poor disease-free survival risk factors.
authors.affiliation: From the Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou; Chang Gung University (C-YW, C-FW, M-JH, Y-HL, Y-CW); Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou; Chang Gung University (J-YF); Division of Chest and Critical Care, Department of Internal Medicine, Change Gung Memorial Hospital, Taoyuan; Chang Gung University (C-TY); and Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi; Chang Gung University (Y-HT).
authors.forename: Ching-Yang
authors.initials: CY
authors.lastname: Wu
authors.forename: Jui-Ying
authors.initials: JY
authors.lastname: Fu
authors.forename: Ching-Feng
authors.initials: CF
authors.lastname: Wu
authors.forename: Ming-Ju
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Yun-Hen
authors.initials: YH
authors.lastname: Liu
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Wu
authors.forename: Cheng-Ta
authors.initials: CT
authors.lastname: Yang
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
mesh_terms: D000367:Age Factors; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010994:Pleura / Q000473:pathology; D011013:Pneumonectomy / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate