Prognostic significance of histologic differentiation, carcinoembryonic antigen value, and lymphovascular invasion in stage i non-small cell lung cancer
Journal
Journal of Thoracic and Cardiovascular Surgery
Journal Volume
148
Journal Issue
4
Pages
1200-1207000
Date Issued
2014
Abstract
Objective: For stage I non-small cell lung cancer (NSCLC), the only 2 prognostic factors incorporated into the seventh edition of the TNM staging system were tumor size and visceral pleural invasion. However, with this staging system, the prognostic precision of survival has proved elusive, suggesting the need to include additional prognostic factors. To improve prognostic applications and treatment decisions, we investigated clinicopathologic factors affecting progression-free survival in patients with surgically resected stage I NSCLC.Methods: From January 2004 to December 2011, we retrospectively reviewed the clinicopathologic characteristics of 758 consecutive patients with surgically resected stage I NSCLC at the National Taiwan University Hospital.Results: The 5-year progression-free survival rate was 82.3%and 64.0%for those with stage IA (n = 481) and stage IB (n = 277), respectively. Multivariate analysis revealed poor or moderate histologic differentiation and elevated preoperative serumcarcinoembryonic antigen were statistically significant risk factors for recurrence in patients with stage IA. Poor or moderate histologic differentiation, elevated preoperative serum carcinoembryonic antigen, lymphovascular invasion, and tumor size 2 cm were statistically significant risk factors for recurrence in patients with stage I NSCLC. The 5-year progression-free survival rate was 93.0%, 73.8%, and 40.6% for stage I patients with no, 1 or 2, and < 2 risk factors, respectively (P < .001).Conclusions: In addition to tumor size, we identified 3 other independent risk factors for recurrence in patients with stage I NSCLC. These 3 risk factors warrant consideration as additional predictors in the next version of the TNM staging system. ? 2014 The American Association for Thoracic Surgery.
SDGs
Other Subjects
carcinoembryonic antigen; carcinoembryonic antigen; tumor marker; adult; aged; Article; bone scintiscanning; breast cancer; cancer grading; cancer patient; cancer prognosis; cancer recurrence; cancer risk; cancer scintiscanning; cancer surgery; cancer survival; clinical feature; colorectal cancer; controlled study; female; follow up; histopathology; human; human tissue; liver cell carcinoma; lymph vessel metastasis; major clinical study; male; malignant pleura effusion; medical record review; needle biopsy; non small cell lung cancer; nuclear magnetic resonance imaging; overall survival; progression free survival; protein blood level; retrospective study; tissue differentiation; tumor biopsy; tumor volume; cancer staging; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; lymph node metastasis; middle aged; pathology; pleura; prognosis; risk factor; thoracotomy; tumor invasion; video assisted thoracoscopic surgery; Aged; Carcinoembryonic Antigen; Carcinoma, Non-Small-Cell Lung; Female; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Pleura; Prognosis; Retrospective Studies; Risk Factors; Thoracic Surgery, Video-Assisted; Thoracotomy; Tumor Markers, Biological
Publisher
Mosby Inc.
Type
journal article