title: Pulmonary fissure development is a prognostic factor for patients with resected stage I lung adenocarcinoma.
abstract: BACKGROUND
  Pulmonary fissure differs among patients, but the relationship between pulmonary fissure development and survival in patients with resected lung adenocarcinoma has not been evaluated. In this study, we analyzed the effect of fissure development on prognosis in patients with stage I lung adenocarcinoma.
  
  
  METHODS
  From January 2009 to December 2012, data, including pulmonary fissure development, were collected prospectively for all lung cancer, and this was a retrospective study of prospectively collected data. In total, 297 patients who had undergone a lobectomy and had pathologic stage I adenocarcinoma were analyzed. Patients were categorized into two groups based on fissure sum average (FSA) fissure development scores. Group A patients ranged from complete to 30% incomplete (0 ≤ FSA ≤ 1) while in Group B patients development was more than 30% incomplete (1 < FSA ≤ 3).
  
  
  RESULTS
  In univariate analysis, Group B had poorer overall 5 year survival than did Group A (83.1% vs. 96.5%, P = 0.015). Multivariate analysis revealed that the level of fissure development was a significant prognostic factor for overall survival (HR = 3.905, CI = 1.168-13.057, P = 0.027).
  
  
  CONCLUSIONS
  The overall survival of patients with resected stage I adenocarcinoma was adversely affected by incomplete fissure development. J. Surg. Oncol. 2016;114:848-852. © 2016 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seokkee
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea. csjglee@yuhs.ac.
authors.forename: Jin Gu
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Chang Young
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Dae Joon
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyung Young
authors.initials: KY
authors.lastname: Chung
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 / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000473:pathology* / Q000601:surgery; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D020775:Thoracic Surgery, Video-Assisted
keywords: adenocarcinoma; non-small cell lung cancer; pleura; prognosis