Stage I nonsmall cell lung cancer. A multivariate analysis of treatment methods and patterns of recurrence

摘要: Background. Nonsmall cell lung cancer (NSCLC) has become the leading cause of cancer-related deaths in women and men United States, with more than 157,000 estimated 1995. Surgical resection remains mainstay therapy Stage I II disease. However, local distant recurrence account for disappointing survival rates after resection. Appropriate selection surgical procedures effective use adjuvant therapies will depend upon elucidation prognostic factors that predict recurrence. Methods. A detailed analysis was undertaken to evaluate define risk associated death 289 consecutive patients NSCLC who were diagnosed, resected followed at Duke University Medical Center from January 1, 1980, until December 31, 1988. These had no evidence metastases on head chest/abdominal computed tomograms radionuclide bone scans before Resected specimens these pathologic verification Follow-up complete all cases through 8/1/94 (median, 61 months). Variables analyzed included age, sex, smoking history, presenting signs symptoms, operative procedure, histopathology, hospital course including complications, time location any or death. Results. The 30-day mortality rate 5 (1.7%), minor major morbidity 17% 9%, respectively. Statistical comparison lobectomy (193) wedge (75) pneumonectomy (21) revealed significantly (P < 0.04) smaller tumors (T1), comorbidity, fewer complications patients. trend 0.09) toward an increased local/regional difference also observed One hundred five died (13-month median recurrence) actual 5-year 63%. Significant univariate predictors early decreased 0.01) were: male presence hemoptysis, chest pain, type cough, tumor size cm by T-classification, visceral pleural invasion, high mitotic index, vascular invasion. 0.05) multivariate independent variables greater 3 cm. Conclusion. Current stage acceptable rate. current data stratify into low populations can be used future randomized trials therapy.