title: Extracapsular extension is a powerful prognostic factor in stage IIA-IIIA non-small cell lung cancer patients with completely resection.
abstract: The purpose of this study is to evaluate the relationship between extracapsular extension (ECE) and clinicopathology, and its influence on the prognosis in non-small cell lung cancer (NSCLC) patients. Clinical data from 388 stage IIA-IIIA NSCLC patients who underwent curative resection and confirmed ECE positive were reviewed. The Fisher's exact or Chi-square test was used to analyze the associations between ECE and the clinical pathology. The log-rank test and Cox regression model were used to evaluate the factors influencing disease-free survival (DFS) and overall survival (OS). ECE was detected in 85 (21.9%) patients, and it had a significant correlation with advanced T stage, pathological stage and histologic type of adenocarcinoma. For the whole population, the median OS was 39.0 months, and the 5-year OS rate was 33.9%. In multivariate analysis, both ECE status and postoperative chemotherapy were significant factors for OS. The median DFS for all patients was 26.0 months, and the 5-year DFS rate was 21.7%. In multivariate analysis, pathologic stage, ECE, and postoperative chemotherapy were the independent predictor factors for DFS. Further analysis found that the locoregional recurrence-free survival and the distant recurrence-free survival rates in ECE negative group were also significantly higher than in the ECE positive group. For NSCLC patients with lymph node metastasis, the presence of ECE occurs more frequently in advanced stage and histologic type of adenocarcinoma and it may be a powerful prognostic factor which reflects the aggressive biological behavior.
authors.affiliation: Department of Pain Management and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer Tianjin 300060, P. R. China.
authors.forename: Weishuai
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Pain Management and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer Tianjin 300060, P. R. China.
authors.forename: Yuejuan
authors.initials: Y
authors.lastname: Shao
authors.affiliation: Department of Pain Management and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer Tianjin 300060, P. R. China.
authors.forename: Bingqing
authors.initials: B
authors.lastname: Guan
authors.affiliation: Department of Pain Management and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer Tianjin 300060, P. R. China.
authors.forename: Jianlei
authors.initials: J
authors.lastname: Hao
authors.affiliation: Department of Pain Management and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer Tianjin 300060, P. R. China.
authors.forename: Xianjiang
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Pain Management and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer Tianjin 300060, P. R. China.
authors.forename: Kai
authors.initials: K
authors.lastname: Ji
authors.affiliation: Department of Pain Management and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer Tianjin 300060, P. R. China.
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Non-small cell lung cancer; extracapsular extension; prognosis; surgery