Survival in Operated Early and Local Advanced-Stage (IA-IIIA) Non-Small Cell Lung Cancer

ABSTRACTObjective: The early and local advanced stages (IA-IIIA) of non-small cell lung cancer (NSCLC) warrant the curative treatment approach of surgery. However, despite the surgical approach, survival depends on a number of factors. The aim of the study was to examine the factors that affect survival in operated NSCLC patients with these stages.Methods: A cohort of 231 operated patients with IA, IB, IIA, IIB, and IIIA stages of NSCLC were analyzed. The effects of age, sex, comorbidity, performance status, histopathology of the tumor, T stage, N stage, pleural invasion, surgical resection type and postoperative resection margin invasion on the survival of the patients were examined with Kaplan-Meier and Cox Regression analyses.Results: Advanced age (OR=1.042 for every passing year, CI=1.020-1.064), adenocarcinoma histopathology (OR=1.676 CI=1.178-2.384), N2 invasion (OR=2.389 CI=1.46-4.239), pleural invasion (OR=2.403 CI=1.569-3.678), resection margin invasion (OR=2.401, CI=1.141-5.048) and pneumonectomy as the type of surgical operation (OR=2.313, CI=1.467-3.647) were found to be independent prognostic factors of mortality.Conclusion: Follow-up of the NSCLC cases with advanced age, an adenocarcinoma type, visceral pleural invasion, N2-lymph node invasion, a history of pneumonectomy, and a resection margin invasion should be undertaken more attentively during planning of surgical operation and postoperative period. J Clin Exp Invest 2016; 7 (2): 125-133Key words: Survival, mortality, performance score, operated, non-small cell lung cancer

Keywords:

Survival, mortality, performance score, operated non-small cell lung cancer,

PDF

___

1. Scott WJ, Howington J, Feigenberg S, et al. Treatment of non-small cell lung cancer stage I and stage II: ACCP evidence-based clinical practice guidelines (2 nd edition). Chest. 2007;132:234s-42s. 2. Birim O, Zuydendorp HM, Maat AP, et al. Lung resection for non-small-cell lung cancer in patients older than 70: mortality, morbidity, and late survival compared with the general population. Ann Thorac Surg. 2003;76:1796-801. 3. Thorsteinsson H, Alexandersson A, Oskarsdottir GN, et al. Resection rate and outcome of pulmonary resections for non-small-cell lung cancer: a nationwide study from Ice - land. J Thorac Oncol. 2012;7:1164-9. 4. Oskarsdottir GN, Skuladottir R, Isaksson HJ, et al. [Factors predictive of survival after lobectomy for non-small cell lung cancer in Iceland during 1999-2008]. Laeknabladid. 2010;96:251-7. 5. Yu DP, Bai LQ, Xu SF, et al. [Impact of TNM staging and treatment mode on the prognosis of non-small cell lung cancer]. Zhonghua zhong liu za zhi [Chinese J Oncol]. 2009;31:465-8. 6. Oken MM, Creech RH, Tormey DC, et al. Toxicity and re - sponse criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649-6. 7. Goldstraw P. The 7 th Edition of TNM in Lung Cancer: what now? J Thoracic Surg Oncol. 2009;4:671-3. 8. Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statis - tics, 2000. CA Cancer J Clin. 2000;50:7-33. 9. Liu M, Cai X, Yu W, et al. Clinical significance of age at diagnosis among young non-small cell lung cancer patients under 40 years old: a population-based study. Oncotarget. 2015;6:44963-70 10. Radzikowska E, Glaz P, Roszkowski K. Lung cancer in women: age, smoking, histology, performance status, stage, initial treatment and survival. Population-based study of 20 561 cases. Ann Oncol. 2002;13:1087-93. 11. Radzikowska E, Głaz P, Roszkowski K. Lung cancer in women: age, smoking, histology, performance status, stage, initial treatment and survival. Population-based study of 20 561 cases. Ann Oncol. 2002;13:1087-93. 12. Visbal AL, Williams BA, Nichols FC, et al. Gender differ - ences in non–small-cell lung cancer survival: an analysis of 4,618 patients diagnosed between 1997 and 2002. Ann Thorac Surg. 2004;78:209-15. 13. Alexiou C, Onyeaka CV, Beggs D, et al. Do women live longer following lung resection for carcinoma? Eur J Car - diothorac Surg. 2002;21:319-25. 14. Kawaguchi T, Takada M, Kubo A, et al. Performance status and smoking status are independent favorable prognostic factors for survival in non-small cell lung cancer: a compre - hensive analysis of 26,957 patients with NSCLC. J Thorac Oncol. 2010;5:620-30. 15. Patz EF, Rossi S, Harpole DH, et al. Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer. Chest. 2000;117:1568-71. 16. Harpole DH, Herndon JE, Young WG, et al. Stage I nons - mall cell lung cancer. A multivariate analysis of treatment methods and patterns of recurrence. Cancer. 1995;76:787- 96. 17. Ma Q, Liu D, Guo Y, et al. Surgical therapeutic strategy for non-small cell lung cancer with mediastinal lymph node metastasis (N2). Zhongguo Fei Ai Za Zhi. 2010;13:342-8. 18. Dai Y, Su XD, Long H, et al. Survival analysis of 220 pa - tients with completely resected stage-II non-small cell lung cancer. Chinese J Cancer. 2010;29:538-44. 19. Lakha S, Gomez JE, Flores RM, Wisnivesky JP. Prognostic significance of visceral pleural involvement in early-stage lung cancer. Chest. 2014;146:1619-26. 20. Kang JH, Kim KD, Chung KY. Prognostic value of visceral pleura invasion in non-small cell lung cancer. Eur J Cardio - thorac Surg. 2003;23:865-9. 21. Naito Y, Goto K, Nagai K, et al. Vascular invasion is a strong prognostic factor after complete resection of node-negative non-small cell lung cancer. Chest. 2010;138:1411-7. 22. Ruffini E, Asioli S, Filosso PL, et al. Significance of the presence of microscopic vascular invasion after complete resection of Stage I-II pT1-T2N0 non-small cell lung can - cer and its relation with T-Size categories: did the 2009 7th edition of the TNM staging system miss something? J Tho - rac Oncol. 2011;6:319-26. 23. Chandrachud L, Pendleton N, Chisholm D, et al. Relation - ship between vascularity, age and survival in non-small-cell lung cancer. Brit J Cancer. 1997;76:1367-70. 24. Naruke T, Tsuchiya R, Kondo H, Asamura H. Prognosis and survival after resection for bronchogenic carcinoma based on the 1997 TNM-staging classification: the Japanese expe - rience. Ann Thorac Surg. 2001;71:1759-64. 25. Kates M, Swanson S, Wisnivesky JP. Survival following lobectomy and limited resection for the treatment of stage I non-small cell lung cancer<=1 cm in size: a review of SEER data. Chest. 2011;139:491-6. 26. Kim DJ, Lee JG, Lee CY, et al. Long-term survival follow - ing pneumonectomy for non-small cell lung cancer: clinical implications for follow-up care. Chest. 2007;132:178-84. 27. Martini N, Bains MS, Burt ME, et al. Incidence of local recurrence and second primary tumors in resected stage I lung cancer. J Thorac Cardiovasc Surg. 1995;109:120-9. 28. Drukin E, Preis VG, Mikhnin AE, et al. [Analysis of one-year mortality of radically operated patients over 70 years with nonsmall cell lung cancer]. Voprosy Onkologii. 2014;60:88-93. 29. Ng CS, Lee TW, Wan S, et al. Thoracotomy is associated with significantly more profound suppression in lympho - cytes and natural killer cells than video-assisted thoracic surgery following major lung resections for cancer. J Invest Surg. 2005;18:81-8. 30. Poullis M, McShane J, Shaw M, et al. Bronchial resection margin and long-term survival in non-small-cell lung can - cer. Asian Cardiovasc Thorac Ann. 2012;20:432-8. 31. Yue D, Wang C. [Surgical resection standard and prognostic analysis of non-small cell lung cancer]. Zhonghua Zhong Liu Za Zhi. 2014;36:532-5.