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A clinical model to estimate recurrence risk in resected stage I non-small cell lung cancer
- Source :
- American journal of clinical oncology. 31(1)
- Publication Year :
- 2008
-
Abstract
- Objective: There are no reliable markers to predict recurrence in resected Stage I non-small cell lung cancer (NSCLC). A validated clinical model to estimate the risk of recurrence would help select patients for adjuvant therapy. Methods: We reviewed the medical records of 715 patients who had a potentially curative resection for Stage I NSCLC at our institution from 1990 to 2000. Recurrence rates were estimated by the Kaplan-Meier method. A model to estimate risk of recurrence was developed by combining independent risk factors. Results: With a median follow-up of 4.7 years, the 5-year survival rates for Stages IA and IB were 66% and 55% respectively, and 5-year recurrence rates were 19% and 30%, respectively. Four factors were independently associated with tumor recurrence: tumor size >3 cm (hazard ratio [HR] = 2.4), surgery other than lobectomy (HR = 2.0), nonsquamous histology (HR = 1.4), and high-grade cellular differentiation (HR = 1.4). A scoring system for recurrence was developed by assigning 2 points for each major risk factor (tumor size and surgery) and 1 point for each minor risk factor (histologic subtype and cellular grade). Scores were grouped as low (0–1), intermediate (2–3), and high (>3), yielding 5-year estimates of risk of recurrence of 14%, 27%, and 43%, respectively. Conclusion: This model, based upon readily available clinicopathologic characteristics, can estimate the risk of recurrence in Stage I NSCLC, independent of T classification. This model could be used to select patients for adjuvant therapy if validated in independent data sets.
- Subjects :
- Oncology
Male
Cancer Research
medicine.medical_specialty
Lung Neoplasms
Adenocarcinoma
Models, Biological
Medical Records
Cohort Studies
Risk Factors
Internal medicine
Carcinoma, Non-Small-Cell Lung
Carcinoma
medicine
Adjuvant therapy
Humans
Risk factor
Survival rate
Aged
Neoplasm Staging
Retrospective Studies
business.industry
Medical record
Hazard ratio
Retrospective cohort study
Middle Aged
medicine.disease
Survival Rate
Carcinoma, Squamous Cell
Carcinoma, Large Cell
Female
Neoplasm Recurrence, Local
business
Cohort study
Follow-Up Studies
Subjects
Details
- ISSN :
- 1537453X
- Volume :
- 31
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- American journal of clinical oncology
- Accession number :
- edsair.doi.dedup.....f294b883ba8fb69b250f597a639744e2