Survival Prediction Model Using Clinico-Pathologic Characteristics for Nonsmall Cell Lung Cancer Patients After Curative Resection

Abstract

The current TNM staging system did not provide disease relapse information. The aim of study was try to establish a predictive survival model for disease and overall survival in nonsmall cell lung cancer patients who presented as resectable disease and to develop a reference for follow-up imaging tool selection.From January 2005 to December 2011, 442 patients who initially presented as resectable disease (stages I–IIIa) and received anatomic resection and mediastinal lymph node dissection were included in the study.Medical charts were thoroughly reviewed and clinico-pathologic factors were collected and analyzed.Visceral pleural invasion, tumor size >5 cm, and postoperative adjuvant therapy were identified as risk factors for poorer disease-free survival. The 5-year disease-free survival from score 0 to 3 was 68.7%, 46.6%, 31.9%, and 26.1%, respectively. The disease relapse percentage for scores 0 to 3 were 26.49%, 50.61%, 65.05%, and 73.81%, respectively. For analysis of overall survival, age >60 years, tumor size >3 cm, and total metastatic lymph node ratio >0.05 were correlated to worse overall survival. Because greater age may be correlated with poor general condition, we re-scored risk factors that correlated to disease severity that ranging from 0 to 2. The 5-year overall survival range from score 0 to 2 was 56.3%, 43.1%, and 13.1%, respectively.Poor prognostic factors correlated to disease-free survival were tumor size >5 cm, visceral pleural invasion, and patients needing to receive postoperative adjuvant therapy. Disease-free survival of resectable nonsmall cell lung cancer patients and disease relapse can be stratified by these 3 factors. Chest tomography may be recommended for patients with 1 or more poor disease-free survival risk factors.

Circulating Tumor Cells as a Tool of Minimal Residual Disease Can Predict Lung Cancer Recurrence: A longitudinal, Prospective Trial

“…Among these clinical scenarios, primary pulmonary malignancy is a major concern, and tissue proof or resection is recommended if images change in the serial follow-up. In patients who underwent tumor resection and were confirmed with primary pulmonary malignancy, the risk of disease relapse was the major concern whereby the reported early relapse in patients with resectable non-small cell lung cancer is 10-19% [5,29]. Many prognostic factors have been identified but can only be used for surveillance planning [3][4][5], instead of relapse prediction [30].…”

“…For patients with lung cancer who present with resectable disease, Diagnostics 2020, 10, 144 2 of 15 the major factor that affects patients' survival is recurrence. A literature review revealed that many relapse risk factors have been identified from clinicopathologic characteristics, and prediction models have been proposed [3][4][5][6]. These findings have been used to identify high-risk patients and for the planning of personalized surveillance programs.…”

Comparison of the 7th and proposed 8th editions of the AJCC/UICC TNM staging system for non-small cell lung cancer undergoing radical surgery

“…Several studies demonstrated such result. Wu CY et al 16 has established a predictive survival model for survival in patients with NSCLC who received radical resection and identified tumor size, visceral pleural invasion, and patients with lymph node metastasis as independent prognostic factor for DFS. Huang H et al 17 reported that visceral pleural invasion is a size-independent poor prognostic factor in stage I NSCLC patients.…”

Antiangiogenesis Roles of Exosomes with Fei‐Liu‐Ping Ointment Treatment are Involved in the Lung Carcinoma with the Lewis Xenograft Mouse Model

“…Due to the lack of specific early symptoms, the patients with lung cancer are neglected in initial stage and are frequently diagnosed in an advanced stage. Management of lung cancer usually entails radiotherapy, chemotherapy, targeted therapy, and immunotherapy following surgery [3]; however, the five-year survival rate is only approximately 25-30% [4,5]. And, thus, it is imperative to develop novel antitumour drugs or methods for alleviating or postponing the progress of lung cancer.…”