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Tumor necrosis as a prognostic factor for stage IA non-small cell lung cancer

Authors
 Seong Yong Park  ;  Hyun-Sung Lee  ;  Jae Ill Zo  ;  Kyung Young Chung  ;  Geon Kook Lee  ;  Hee-Jin Jang 
Citation
 Annals of Thoracic Surgery, Vol.91(6) : 1668-1673, 2011 
Journal Title
 Annals of Thoracic Surgery 
ISSN
 0003-4975 
Issue Date
2011
Abstract
BACKGROUND: In stage IA non-small cell lung cancer (NSCLC), lobectomy and mediastinal lymph node dissection is considered the standard treatment. However, 20% to 30% of patients have cancer recurrences. The purpose of this study was to determine the patterns and risk factors for recurrence in patients with stage IA NSCLC. METHODS: We retrospectively reviewed the medical records of 201 patients who had confirmed stage IA NSCLC by lobectomy and complete lymph node dissection. RESULTS: There were 131 male patients with a mean age of 60.68±9.26 years. The median follow-up period was 41.4 months. Recurrences were reported in 16 patients. One hundred fourteen and 87 patients were T1a (≤2 cm) and T1b (>2 cm to ≤3 cm), respectively. The pathologic results were as follows: adenocarcinomas and bronchioloalveolar carcinomas (n=134); squamous cell carcinomas (n=57); and other diagnoses (n=10). Tumor necrosis and lymphatic invasion were significant adverse risk factors for recurrence based on univariate analysis. Multivariate analysis showed that tumor necrosis was the only significant risk factor to predict cancer recurrence (hazard ratio, 4.336; p=0.032). The 5-year overall survival was 94.8% for necrosis-negative patients and 86.2% for necrosis-positive patients (p=0.04). The 5-year disease-free survival was 92.1% for necrosis-negative patients and 78.9% for necrosis-positive patients (p=0.016). CONCLUSIONS: Tumor necrosis was shown to be an adverse risk factor for survival and recurrence in patients with stage IA NSCLC. Thus, close observation and individualized adjuvant therapy might be helpful for patients with stage IA NSCLC with tumor necrosis.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93995
DOI
10.1016/j.athoracsur.2010.12.028
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic & Cardiovascular Surgery (흉부외과학교실)
Yonsei Authors
정경영(Chung, Kyung Young)
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Full Text
http://www.sciencedirect.com/science/article/pii/S0003497510029152
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