Operative invasiveness does not affect the prognosis of patients with non-small cell lung cancer

Abstract

Background The relationship between operative invasiveness and the prognosis in non-small cell lung cancer (NSCLC) patients who have undergone surgery has been controversial. Methods Clinical data were analyzed for 463 NSCLC patients. Operative invasiveness was defined by wound length, operation time, and the postoperative C-reactive protein (postCRP) level. The operative approach was divided into video-assisted thoracic surgery (VATS) and thoracotomy. Results The wound length and operation time were significantly correlated with the postCRP level (correlation coefficient (CC) = 0.39, p < 0.01; CC = 0.54, p < 0.01, respectively). The postCRP level in the VATS group was significantly lower than that in the thoracotomy group (12.2 mg/dl vs 20.58 mg/dl, p < 0.01). The relapse-free survival differed significantly based on wound length (p < 0.01), operation time (p = 0.01), CRP level (p < 0.01), and operative approach (p < 0.01). The carcinoembryonic antigen level (hazard ratio [HR], 1.58; p = 0.02), pathological stage (pStage) (HR, 2.57; p < 0.01), vascular invasion (HR, 1.95; p = 0.01), and preoperative CRP level (preCRP) (HR, 1.91; p < 0.01) were identified as significant prognostic factors for relapse-free survival in a multivariate analysis. Furthermore, the multivariate analysis showed that smoking history (HR, 2.36; p = 0.03), pStage (HR, 3.26; p < 0.01), and preCRP level were significant prognostic factors for overall survival. Conclusion Preoperative CRP level was associated with poor prognosis. Although the VATS approach might be less invasive procedure for NSCLC patients, operative invasiveness does not affect the prognosis.

Interstitial Lung Disease and Partial Resection Are Poor Prognostic Factors for pStage IA NSCLC: a Retrospective Study

“…However, the relationship between prognosis and operative approaches such as VATS or RATS in NSCLC patients who have undergone pulmonary resection has not been elucidated. Our previous study revealed that operative invasiveness does not affect the prognosis of patients with NSCLC [29]. Because VATS and RATS were not prognostic factors in the present study, the operative approach therefore does not in uence the prognosis of NSCLC patients.…”

Complete Video-Assisted Thoracoscopic Surgery and Traditional Open Surgery for Elderly Patients With NSCLC

“…In fact, in addition to the macroscopic indexes of clinical trauma, the evaluation of the effects of the two kinds of surgery can also be analyzed in the macroscopic aspect. In the case of infection or some tissue damage, CRP content usually increases rapidly, and it is a non-specific inflammatory marker (17,18). In this study, the serum CRP levels in the observation group at each time point postoperative were significantly lower than those in the control group.…”

Is a high preoperative HbA1c level a risk factor for postoperative complications in patients with non-small-cell lung cancer?

“…Originally, glycolysis was considered important for tumor metabolism and growth, manifesting as a heightened glucose uptake rate [ 4 ]. We previously reported that smoking history, vascular invasion, and pStage, but not postoperative complications, were identified as significant prognostic factors in a multivariate analysis of 463 patients with NSCLC [ 24 ]. Recently, however, we showed the clinical relevance of SGLT2 in resected lung adenocarcinoma, and the expression of SGLT2 was more frequently detected in advanced-stage and more aggressive adenocarcinomas with aggressive biological behavior than in their counterparts.…”