Long-term survival and prognostic factors of five-year survivors with complete resection of non–small cell lung carcinoma

Objective We analyzed the long-term follow-up data on cancer-related death in 5-year survivors of complete resection of their non–small cell lung cancer and examined the prognostic factors having an impact on subsequent survival. Methods Of 848 consecutive patients with proven primary non–small cell carcinoma who underwent complete removal of the primary tumor together with hilar and mediastinal lymph nodes, 421 patients (49.6%) survived 5 years or longer after the initial surgical treatment. Of all the data analyzed, only death related to cancer was treated as death. Results The median follow-up of 5-year survivors was 84 months from the original treatment (range, 60 to 200 months). Their overall survival rate at 10 years was 91.0%. Multivariable Cox analysis demonstrated that although advanced surgical-pathological stage ( P = .0001), nodal involvement ( P = .0245), male gender ( P = .0313), and non–squamous type of the tumor ( P = .0034) were significant, independent, unfavorable prognostic determinants in all patients, none of the variables investigated significantly influenced the long-term survival of 5-year survivors. The rate of recurrence beyond 5 years was much lower compared with that within 5 years. In contrast, the rate of occurrence of new malignancies was unchanged throughout the long-term postoperative period. Conclusions Among 5-year survivors of complete resection of non–small cell lung cancer, neither stage, nodal status, sex, nor histologic condition further affected subsequent survival, suggesting that the 5-year interval might be sufficient to declare that a patient with lung cancer has been cured.