A clinicopathologic prediction model for postoperative recurrence in stage Ia non-small cell lung cancer

作者：Zhang, Yang; Sun, Yihua; Xiang, Jiaqing; Zhang, Yawei; Hu, Hong; Chen, Haiquan^*

来源：The Journal of Thoracic and Cardiovascular Surgery, 2014, 148(4): 1193-1199.

DOI：10.1016/j.jtcvs.2014.02.064

• IASLC/ATS/ERS CLASSIFICATION
• ADJUVANT CHEMOTHERAPY
• PROGNOSTIC VALUE
• ADENOCARCINOMA
• SURVIVAL
• INVASION
• TEGAFUR
• SMOKING
• DISEASE
• URACIL

Objective: Controversy remains over the appropriate postoperative management for patients with stage Ia non-small cell lung cancer who underwent complete surgical resection as a result of a heterogeneous prognosis. We aimed to identify the predictive factors for recurrence in these patients to aid in the decision making. @@@ Methods: We reviewed 344 patients with stage Ia non-small cell lung cancer to analyze the associations between recurrence-free survival and the following clinicopathologic variables: age, gender, smoking history, family history, preoperative serum carcinoembryonic antigen level, type of surgical resection, tumor location, tumor histology, lymphovascular invasion, tumor differentiation, and pathologic T status. @@@ Results: Cox multivariate survival analysis revealed that central tumor location (P = .019), stage T1b (P = .006), high histologic grade (including large cell carcinoma, solid predominant, micropapillary predominant, and invasive mucinous adenocarcinoma, P = .007), poor differentiation (P = .022), and lymphovascular invasion (P = .035) were independently associated with recurrence-free survival. A nomogram for predicting the probability of 3-year recurrence-free survival was developed using the 5 variables. This model shows good calibration, reasonable discrimination (concordance index = 0.733), and small overfitting (2.6%) demonstrated by bootstrapping. @@@ Conclusions: We developed a clinicopathologic prediction model for postoperative recurrence in stage Ia non-small cell lung cancer. This model can help with the selection of appropriate postoperative therapeutic strategies for these patients.

• 出版日期2014-10
• 单位复旦大学